introduction to communication disorders: a lifespan ... · pdf fileintroduction to...

Instructor’s Manual

to accompany

Introduction to Communication Disorders:

A Lifespan Evidence-Based Perspective Fifth Edition

Robert E. Owens, Jr.

College of St. Rose

Kimberly E. Farinella Northern Arizona University

Dale Evan Metz Retired from SUNY Geneseo

Prepared by

Sarah A. Dachtyl, Ph.D., CCC/SLP Sahuarita Unified School District

Tucson Communication Therapies, LLC

Boston Columbus Indianapolis New York San Francisco Upper Saddle River

Amsterdam Cape Town Dubai London Madrid Milan Munich Paris Montreal Toronto

Delhi Mexico City Sao Paulo Sydney Hong Kong Seoul Singapore Taipei Tokyo

Full file at https://testbankgo.info/p/

ii

______________________________________________________________________________

Copyright © 2015, 2011, 2007, 2003 by Pearson Education, Inc., Upper Saddle River, New Jersey 07458. All rights reserved. Printed in the United States of America. This publication is protected by Copyright and

permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system,

or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. For

information regarding permission(s), write to: Rights and Permissions Department.

Pearson® is a registered trademark of Pearson plc

Instructors of classes using Owens/Metz/Farinella’s Introduction to Communication Disorders: A Lifespan

Evidence-Based Perspective, 5e, may reproduce material from the instructor’s manual for classroom use.

10 9 8 7 6 5 4 3 2 1 ISBN-10: 0133598306

ISBN-13: 9780133598308

www.pearsonhighered.com


https://testbankgo.info/p/

3

Table of Contents

Instructor’s Manual: p. 2-91 Test Bank with Answer Key: Chapter 1: p. 93 Chapter 2: p. 99 Chapter 3: p. 110 Chapter 4: p. 117 Chapter 5: p. 132 Chapter 6: p. 140 Chapter 7: p. 154 Chapter 8: p. 160 Chapter 9: p. 169 Chapter 10: p. 176 Chapter 11: p. 184 Chapter 12: p. 194 Chapter 13: p. 206



4

CHAPTER 1 THE FIELD, THE PROFESSIONALS, AND THE CLIENTS

Chapter Learning Goals

1. Describe communication impairment 2. Describe the roles of audiologists, speech/language pathologists, and speech, language, and hearing

scientists 3. Outline the history of changing attitudes toward individuals with disabilities over the centuries and

especially legislation over the past several decades. 4. Describe how evidence-based practice (EBP) influences clinical decisions.

Introduction

Communication is part of what makes us human. We will explore the nature of communication disorders in this text. In the first chapter, we introduce the professionals who work with individuals who have communication disorders. In addition, the roles of other team members will be discussed, as well as evidence-based practice and a historical perspective of laws that mandate appropriate care.

Content Outline

HELPING OTHERS TO HELP THEMSELVES Reasons for becoming a SLP or audiologist vary from person to person. Some may want to contribute to the general good of society, and others may have experience with individuals with communication disorders in their family or circle of friends. COMMUNICATION DISORDERS

A communication disorder may affect any and all aspects of communication; it may affect hearing, language, and/or speech.

Speech disorder: Atypical production of speech sounds, interruption in the flow of speaking, or abnormal production and/or absence of voice quality (pitch, loudness, resonance, and/or duration).

Language disorder: Impairment in comprehension and/or use of spoken, written, and/or other symbol systems.

Hearing disorder: A result of impaired sensitivity of the auditory or hearing system. Central auditory processing disorders: Deficits in the processing of information from audible

signals. Communication disorders are NOT differences, such as dialectal differences or multilingualism. Augmentative/alternative communication systems: Attempts often taught by SLPs to

compensate and facilitate for impaired communication using, for example, signing or digital methods.

THE PROFESSIONALS

Audiologists: Measure hearing and identify, assess, manage, and prevent disorders of hearing (including auditory processing disorders) and balance. They may dispense hearing aids.

Credentials for Audiologists Educational requirements are 3-5 years of professional education beyond the bachelor’s

degree. This culminates in a doctoral degree, either an AuD, PhD, or EdD in audiology. ASHA CCC-A: Requires doctorate, professional experience, national exam. State license is often needed and is frequently identical to ASHA CCC.

Speech-Language Pathologists: Identify, assess, treat, and prevent expressive and receptive communication disorders in all modalities. They provide services for swallowing disorders and may be involved in modifying dialects.

Credentials for SLPs



5

Public schools require at least a bachelor’s degree, but most states require a master's degree. Requirements vary from state to state.

ASHA CCC-SLP: Requires master's degree or doctorate, professional experience, professional development, national exam.

State license often needed and is frequently identical to ASHA CCC. There may also be additional requirements for the state’s department of education school certification.

Speech, Language, and Hearing Scientists: Extend knowledge of human communication processes and disorders. They usually have doctorate degrees and are employed by universities, government agencies, industry, and research centers. Some may also work clinically. ♦ What Speech, Language, and Hearing Scientists Do

Speech scientists may be involved in basic research exploring anatomy, physiology, and physics of speech-sound production.

Investigate the causes, prevention, and treatment of various speech impairments. Development of computer-generated speech. Language scientists may investigate the ways children learn language. Conduct cross-cultural studies of language and communication. Study how languages are changing. Examine language disabilities and the nature of language disorders in children and

adults. Hearing scientists investigate the nature of sound, noise, and hearing. They may help develop equipment for hearing assessment. Develop techniques for testing infants or those with physical or psychological

impairments. Develop and improve assistive listening devices. Concerned with conservation of hearing and limiting environmental noise.

Professional Aides: Work with supervision to assist audiologists and SLPs. Their titles, educational requirements, and responsibilities vary amongst states that permit their employment. They may work only with supervision and there are limits to the tasks in which they can be involved.

Related Professionals: A Team Approach: Teams can include family members, regular and special education teachers, psychologists, social workers, physicians and other medical personnel, and occupational, physical, and music therapists. They may collaborate with physicists and engineers.

SERVICE THROUGH THE LIFESPAN

Individuals with communication disorders may be of any age. 1 in 5 people has a disability, and the likelihood increases as we age. Infants are screened for hearing loss and other disabilities as soon as they are born. Babies and toddlers may exhibit developmental delay. An interdisciplinary approach is necessary in the assessment and treatment of young children,

and an IFSP is developed for each child, which is directed to the entire family. Early intervention is highly valuable and may prevent later difficulties. Preschoolers may attend a special school where professionals can address the child’s needs. Almost half of all SLPs are employed in school systems. School-age children with communication difficulties often experience academic and social

difficulties. 1.5 to 2 million Americans sustain a traumatic brain injury each year and may have subsequent

communication or swallowing impairments. In those over age 65, stroke, neurological disorders, and dementia may interfere with

communication and swallowing. Hearing loss may affect at least one quarter of older adults. Evidence-Based Practice

♦ SLPs and audiologists must provide the most effective intervention based on available evidence.

♦ Clinical decision-making: combination of scientific evidence, clinical experience, and client needs.



6

Assumptions of EBP:

Clinical skill grows from experience and current available data.

The SLP or audiologist seeks new therapeutic information to improve efficacy. ♦ Professional, peer-reviewed journals are the best source of clinical evidence. ♦ ASHA has established the National Center for Evidence-Based Practice in Communication

Disorders, but comprehensive assessment and intervention guidelines are still works in progress.

♦ Efficacy: The probability of benefit from an intervention under ideal conditions. There are three key elements: It refers to an identified population, not specific individuals. The treatment should be focused and the population should be clearly identified. The research should be conducted under optimal intervention conditions, although actual

clinical conditions may be less than ideal. ♦ Effectiveness: The probability of benefit from an intervention method under average

conditions. It is what works in real-world application of intervention. ♦ Efficiency: The quickest and least effortful method resulting in the greatest positive benefit. ♦ Additional factors affecting clinical decision making include the clinician’s expertise,

experience, attitude, and motivation, client/family values and characteristics, and service delivery variables.

♦ Providing the best intervention possible is of foremost concern. Intervention options and supporting evidence should be discussed with clients and/or family members.

COMMUNICATION DISORDERS IN HISTORICAL PERSPECTIVE

Disorders are not new but attitudes toward them have changed throughout the centuries. By the late 1700s, special residences were designed for individuals with specific disorders. The first U.S. “speech correctionists” were educators and others who took an interest in speech

problems. The first professional journal related to communication, The Voice, was established in 1879. Early interest groups included teachers within the National Education Association and the

National Association of Teachers of Speech. The American Academy of Speech Correction was formed in 1925, a precursor to ASHA. Audiology became a profession in the 1920s and experienced a boom in the 1940s due to World

War II veterans who were experiencing noise-induced hearing loss. The American Coalition of Citizens with Disabilities was created in 1974. Select federal mandates affecting people with communication disabilities:

1975: Education for All Handicapped Children Act (EAHCA) (Public Law 94-142) Mandated that a free and appropriate public education (FAPE) must be provided for all

handicapped children between ages 5 and 21.

1986: Education of the Handicapped Amendments (Public Law 99-457) Extended age of those served to cover children between the ages of birth and 5 years.

1990: Individuals with Disabilities Education Act (IDEA) Addressed the multicultural nature of the U.S.

2004: Reauthorization of IDEA Established birth-to-6 programs as well as new early intervention services.

Summary

SLPs, audiologists, and other specialists work to assist individuals with communication impairments. They work in a variety of settings and with people throughout the lifespan. Clinicians have a minimum of a master’s degree and supervised clinical experience, and generally have the ASHA CCCs. ASHA is the largest organization of professionals working with communication disorders. ASHA’s missions include the scientific study of human communication, provision of clinical service in speech/language pathology and audiology, maintenance of ethical standards, and advocacy for individuals with communication disabilities. Federal legislation currently mandates services for people with disabilities.



7

Suggested Resources Print Resources Nicolosi, L., Harryman, E., & Kresheck, J. (2003). Terminology of communication disorders: Speech, language, and hearing (5th ed.). Baltimore: Williams & Wilkins. Peterson’s Guides (Ed.). (2013). Graduate & Professional Programs: An overview 2013. Princeton, NJ: Peterson’s (published annually). Singh, S. (Ed.). (2000). Singular’s illustrated dictionary of speech-language pathology. San Diego: Singular.

Audiovisual and Online National Institute on Deafness and Other Communication Disorders (NIDCD): www.nidcd.nih.gov American Academy of Audiology (AAA): http://www.audiology.org American Speech-Language-Hearing Association (ASHA): http://asha.org Acoustical Society of America (ASA): http://asa.aip.org Peterson's Guide to Graduate and Professional Study: http://www.petersons.com/

Suggested Activities

1. Ask students why they are taking this course. 2. Arrange for students to shadow a speech-language pathologist or audiologist for a day. After writing a

journal of their observations, students can compare notes in class. 3. Have students interview a person with a communication disorder or have an individual visit the class.

How was this person's life affected by the disorder? What kind of help has the person received? Students can prepare additional questions.

4. Project the ASHA website to demonstrate the available resources for students. 5. Invite fellow faculty members to class to briefly describe their research projects to show students what

speech, language, and hearing scientists in their department are involved in.



8

CHAPTER 2 TYPICAL AND DISORDERED COMMUNICATION

Chapter Learning Goals

1. Explain the role of culture and environment in communication. 2. Describe what is involved in human communication. 3. Demonstrate how communication disorders may be classified. 4. Name some types of communication disorders. 5. Discuss and estimate the frequency of occurrence of communication disorders. 6. Describe in general the assessment and intervention process.

Content Outline HUMAN COMMUNICATION

The Social Animal

Communication: An exchange of ideas between sender(s) and receiver(s).

Sociolinguistics: How cultural identity, setting, and participants influence communication.

Cultural Identity Refers to our language and cultural communities (nationality, age, gender, ethnicity, etc.).

Means of Communication ♦ Language: A socially shared tool that is used to represent concepts. It uses arbitrary

symbols that are combined in rule-governed ways. Grammar refers to the rules of a language. Linguistic intuition is the recognition of "right" or "wrong" grammar by native speakers. Generative means that each utterance is freshly created. Dynamic means that languages change over time. All languages have three primary components: Form, Content, and Use. Form consists of phonology, morphology, and syntax.

Phonology is the sound system of a language.

Phonotactic rules specify how sounds may be arranged in words.

Morphology involves the structure of words.

Morphemes are the smallest grammatical units in a language.

Free morphemes may stand alone as a word.

Bound morphemes change the meaning of the original words and can only be attached to free morphemes.

Syntax is how words are arranged in a sentence and the ways in which one word may affect another.

Content consists of semantics.

Semantics refers to the content or meaning of language.

Semantic features are pieces of meaning that define a particular word. Use consists of pragmatics, which is how and why we use language. Pragmatic rules

vary with culture. ♦ Speech: The process of producing the acoustic representation of language.

Articulation is the way speech sounds are formed. Fluency is the smooth, forward flow of communication, influenced by rhythm and rate.

Rate is the speed at which we talk.

Rate and rhythm are components of prosody, or speech suprasegmentals. ♦ Voice can reveal things about the speaker and the message.

Both the overall level of loudness and the loudness pattern within sentences and words are important.

Pitch is a listener’s perception of how high or low a sound is (frequency) Habitual pitch is the basic tone that an individual uses most of the time. Intonation is the pitch movement within an utterance.



9

♦ Nonverbal Communication: About 2/3 of human meaning exchange is nonverbal. Nonverbal encompasses both the suprasegmental aspects of speech and the nonvocal and nonlinguistic aspect of communication. Artifacts: How you look, your clothes, your possessions, music you listen to, etc. Kinesics: The way we move our body, or body language.

Explicit movements are clearly defined.

Implicit movements are more general or subtle. Space and Time

Proxemics is the physical distance between people as it affects communication.

Tactiles are touching behaviors.

Chronemics is the effect of time on communication. COMMUNICATION THROUGH THE LIFESPAN

Infants must first learn the rudiments of communication and begin to master speech. The early establishment of communication between children and caregivers fosters the

development of speech and language, which influence the quality of communication. This is complicated by physical, cognitive, and social development. The key to becoming a communicator is being treated as one. The process of learning speech and language is a social one that occurs through interactions of

children and the people in their environment. Every person’s speech and language continues to change until the end of life. A competent communicator continues to adapt to changes in the language and in the

communication process. COMMUNICATION IMPAIRMENTS

Communication disorders consist of disorders of speech (articulation, voice, resonance, fluency), oral neuromotor patterns of control and movement, language impairment, feeding and swallowing disorders, cognitive and social communication deficits, and hearing and processing difficulties.

May be categorized on the basis of whether reception, processing, and/or expression are affected.

Etiology is the cause/origin of a problem, and may be used to classify a communication problem. ♦ Faulty learning, neurological impairments, anatomical or physiological abnormalities,

cognitive deficits, hearing impairment, or damage to any part of the speech system. Congenital: Present at birth. Acquired: The result of illness, accident, or environmental circumstances later in life. Severity is also used to characterize communication disorders, ranging from mild to profound. Variations in communication are not impairments. Dialects: Differences that reflect a particular regional, social, cultural, or ethnic identity. A holistic approach to the diagnosis and treatment of people with communication impairments is

used in this text. Language Disorders

Disorders of Form Errors in sound use constitute a disorder of phonology. Incorrect use of past tense or plural markers is an example of a disorder of morphology. Syntactical errors include incorrect word order and run-on sentences. May be due to sensory limitations, perceptual difficulties, limited exposure to correct

models, etc.

Disorders of Content Limited vocabulary, misuse of words, or word-finding problems. Difficulty understanding and using abstract language. May be due to limited experience, concrete learning style, strokes, head trauma, or

certain illnesses.

Disorders of Use



10

Pragmatic impairments may stem from limited or unacceptable conversational, social, and narrative skills; deficits in spoken vocabulary; and/or immature or disordered phonology, morphology, and syntax.

Might include difficulty staying on topic, providing inappropriate or incongruent responses to questions, or continually interrupting the conversational partner.

Speech Disorders: May involve articulation, fluency, or voice.

Disorders of Articulation Articulation: The actual production of speech sounds. It is not always easy to determine whether an individual’s speech-sound errors indicate

an impairment of phonology (a language problem) or articulation. The causes of articulation disorders include neuromotor problems such as cerebral palsy,

physical anomalies such as cleft palate, and faulty learning. Dysarthria is a speech disorder caused by paralysis, weakness, or poor coordination of

the speech musculature. Apraxia of speech is a speech disorder that is due to neuromotor programming

difficulties.

Disorders of Fluency The smooth, uninterrupted flow of speech is affected.

Developmental disfluency: Speech patterns common to young children (~age 3). Fillers: Examples include “er,” “um,” and “ya know.” Hesitations: Unexpected pauses. Repetitions: Sounds or words are repeated, as in “g-go-go.” Prolongations: Excessively long duration, as in “wwwwwwwell.” Stuttering: When these speech behaviors exceed or are qualitatively different from

the norm or are accompanied by excessive tension, struggle, and fear. Fluency disorders are generally first noticed before age 6. Adult onset of stuttering can also occur. The causes of nonfluent speech are typically unclear.

Voice Disorders Congenital physiological conditions can affect voice, but are relatively rare. Vocal abuse: Excessive yelling, screaming, or loud singing. Can result in hoarseness or

another voice disorder. Habits such as physical tension, coughing, throat clearing, smoking, and drinking alcohol

can disrupt normal voice production. Can result in pathology such as polyps, nodules, or ulcers. Other causes: Disease, trauma, allergies, and neuromuscular or endocrine disorders.

Hearing Disorders

Deafness When a person’s ability to perceive sound is limited to such an extent that the auditory

channel is not the primary sensory input for communication. It may be congenital or acquired.

Interventions

Total communication is considered the most effective.

Assistive listening devices, cochlear implants, and auditory training are helpful.

Hard of Hearing People who are hard of hearing depend primarily on audition for communication. Hearing loss may be temporary or permanent. Hearing loss is categorized in terms of severity, laterality, and type.

Severity may range from mild to severe. The loss can be bilateral (involving both hears) or unilateral (involving one ear). The type of loss can be conductive, sensorineural, or mixed.

Conductive: Caused by damage to the outer or middle ear.

Sensorineural: Problems with the inner ear and/or auditory nerve.

Mixed: Both conductive and sensorineural losses. Auditory Processing Disorders



11

Individuals with APD may have normal hearing but difficulty understanding speech. ♦ Difficulty keeping up with conversation, understanding speech in noise, discriminating and

identifying speech sounds, and integrating speech with nonverbals. ♦ Etiology is often unknown, but can be due to tumor, disease, or brain injury. ♦ Can occur in children or adults. ♦ May coexist with other disorders.

How Common Are Communication Disorders? ♦ What is "Normal"?

Variability is the norm. “Typical” is a better term when we mean “like most others of the same group.”

♦ Communication Disorders as Secondary to Other Disabilities. Most communication disorders are secondary to other disabilities. Children with cleft palate also have physical health problems. People with cerebral palsy have more global motor deficits. Children with learning disabilities may also have academic and social difficulties.

♦ Estimates of Prevalence Prevalence: The number/percentage of people within a specified population who have a

particular disorder or condition at a given point in time. About 17% of the U.S. population has a communication disorder. About 11% have a hearing loss. About 6% have a speech, voice, or language disorder. 6-10 million Americans have swallowing disorders; many have communication

impairments. The percentage of people with hearing loss increases with age. Impairments of speech-sound and fluency are more common in children than adults and

more common in males that females. Speech disorders due to neurological disorders or brain and spinal cord injury occur more

often among adults. 3-10% of Americans have voice disorders. Language disorders occur in 8-12% of the preschool population and decreases through

the school years. 5-10% of older adults experience language disabilities related to stroke or dementia.

DECIDING WHETHER THERE IS A PROBLEM

Selection for assessment may come from referral from another professional or concerned adult or from a screening.

Adults may refer themselves. Defining the Problem

♦ Assessment of communication disorders is the systematic process of obtaining information from many sources, through various means, and in different settings to verify and specify communication strengths and weakness, identify possible causes of problems, and make plans to address them.

♦ Diagnosis: Distinguishes an individual’s difficulties from the broad range of possible problems.

Assessment Goals ♦ The primary goal of diagnosis is determining exactly what is wrong. ♦ Diagnostic therapy: Working with the client for a time to obtain a clearer picture of strengths

and weaknesses. ♦ If a problem exists, the SLP should determine severity. ♦ Etiology (cause) should be determined. ♦ Predisposing causes may include genetic factors. ♦ Precipitating factors trigger a disorder ♦ Maintaining or perpetuating causes continue or add to the problem. ♦ Recommendations are part of the assessment report.



12

♦ The SLP makes a prognosis (informed prediction of an outcome) regarding whether the problem will persist if no intervention occurs and what the likely outcome is if a course of therapy or other treatment plan is followed.

Assessment Procedures ♦ Authentic data: Actual real-life information ♦ A clinician should use a variety of procedures. ♦ Norm referenced tests: Yield scores that are used to compare a client with a sample of

similar individuals. ♦ Criterion-referenced tests: Evaluate a client’s strengths and weaknesses with regard to

particular skills. ♦ Dynamic assessment includes probing to explore a client’s ability to modify behavior, as in a

test-teach-retest paradigm. ♦ Speech or language sampling techniques may also be used. ♦ Evidence-Based Practice

Most ASHA assessment guidelines are described in the following chapters. INTERVENTION WITH COMMUNICATION DISORDERS

Providing culturally responsive intervention is extremely important for children from culturally linguistically diverse backgrounds.

Intervention is influenced by the nature and severity of the disorder, the age and status of the client, environmental considerations, and personal/cultural characteristics of client and clinician.

ASHA has established the National Center for Treatment Effectiveness in Communicative Disorders and is currently coordinating a National Institutes of Health-funded effort to promote clinical research that will support EBP.

Objectives of Intervention ♦ The client should show improvement and this should generalize. ♦ What has been learned should be largely automatic. ♦ The client must be able to self-monitor. ♦ The client should make optimum progress in the minimum amount of time. ♦ Intervention should be sensitive to the personal and cultural characteristics of the client.

Target Selection ♦ The client’s personal needs and the potential for intervention to generalize are relevant in

making target selection determinations. ♦ Likelihood of success and typical behaviors of others at the client’s age and gender are also

relevant. Baseline Data

♦ Measurement of the client’s accuracy before beginning intervention. Behavioral Objectives

♦ A statement that specifies the target behavior in an observable and measurable way. ♦ A: Actor: Who is expected to do the behavior? ♦ B: Behavior: What is the observable and measurable behavior? ♦ C: Condition: What is the context or condition of the behavior? ♦ D: Degree: What is the targeted degree of success?

Clinical Elements ♦ Direct Teaching

Behavior modification: A systematic method of changing behavior.

The SLP provides a stimulus and reinforces the response if it is correct or provides corrective feedback if it is not.

♦ Incidental Teaching

The SLP follows the client’s lead but teaches along the way. ♦ Counseling

SLP can provide a supportive environment for the client and other key people in the client’s life.

♦ Family and Environmental Involvement

Family members may be asked to help the client with specific activities at home to foster carryover.



13

Support groups can provide an avenue to practice what has been learned in therapy, share feelings about the disability, and maintain communication skills once formal treatment has been terminated.

Measuring Effectiveness ♦ Post-therapy tests can be used to determine whether clients have met their objectives. ♦ If therapy has been effective, the client is successful in generalizing the learned skills, can

self-correct, and experiences automaticity. Follow-up and Maintenance

♦ Upon dismissal, the client or family should be encouraged to return if there is a need. ♦ A regular follow-up schedule can be established. ♦ Booster treatment may be provided if needed.

Summary

Communication is an exchange of ideas, involving message transmission and response. It is strongly influenced by culture and environment. The primary vehicle of human communication is language. It may be spoken, written, or signed. The three major components are form (phonology, morphology, syntax), content (semantics), and use (pragmatics). Nonverbals play a large role in communication. Any aspect of communication can be impaired. About 17% of Americans have a communication impairment. Assessment of communication disorders requires an understanding of communication in context. Referrals and screenings are the primary ways in which individuals are selected for assessment. Assessment and treatment function in a cyclical fashion, with one influencing the other. Successful intervention often uses a team approach that involves family members as well as professionals.

Suggested Resources Print Resources Axtell, R. (1998). Gestures: The do’s and taboos of body language around the world (Rev. ed.). New York: Wiley. Hirsh-Pasek, K., & Golinkoff, R. (1999). The origins of grammar: Evidence from early language. Cambridge, MA: MIT Press. Ruben, B., & Stewart, L. (2006). Communication and human behavior (5th ed.). Boston: Pearson Education. Audiovisual and Online The ASHA website (www.asha.org) discusses various disorders that affect children and adults. Evidence based practice: http://www.asha.org/members/ebp/ Dynamic assessment: http://www.asha.org/practice/multicultural/issues/Dynamic-Assessment

Suggested Activities

1. Identify the different speech communities represented in your class. What variations in communication can be noted based on this?

2. Based on student experience, attempt to determine the prevalence of communication disorders. Consider: How many students have a disorder? How many have relatives in this situation? Friends? Acquaintances? What percentage is this of the estimated pool of individuals? What type of disorder is most common? What are the weaknesses in this procedure?

3. Use a computer and projector to visit websites for various disabilities. Often sites have video links with examples of various disorders.

4. Have students sign up to observe live therapy sessions or play video clips in class to illustrate both assessment and treatment procedures.

5. Bring formal assessments to class and pass around for students to get an idea of the types of stimuli used.



14

CHAPTER 1

THE FIELD, THE PROFESSIONALS, AND THE CLIENTS

1. A communication disorder may affect

a. Hearing

b. Language

c. Speech

d. All of the above

2. “Atypical production of speech sounds, interruption in the flow of speaking, or abnormal production and/or

absence of voice quality” is the definition of a

a. Speech disorder

b. Language disorder

c. Hearing disorder

d. Central auditory processing disorder

3. “Impairment in comprehension and/or use of spoken, written, and/or other symbol systems” is the definition

of a

a. Speech disorder


c. Hearing disorder


4. “A result of impaired sensitivity of the auditory system” is the definition of a

a. Speech disorder


c. Hearing disorder


5. “Deficits in the processing of information from audible signals” is the definition of a

a. Speech disorder


c. Hearing disorder


6. Attempts taught by SLPs to compensate and facilitate for impaired communication using various methods.

a. Dialects

b. Augmentative/alternative communication

c. Multilingualism

d. All of the above

7. The professionals who measure hearing and identify, assess, manage, and prevent disorders of hearing and

balance are

a. Audiometers

b. Hearing aid dispensers

c. Audiologists

d. Aural rehabilitation professionals



15

8. The professionals who identify, assess, treat, and prevent expressive and receptive communication disorders,

as well as provide services for swallowing disorders and dialect modification are

a. Speech correctionists

b. Speech-language pathologists

c. Speech teachers

d. Speech scientists

9. The professionals who extend knowledge of human communication processes and disorders and usually hold

doctorate degrees are

a. Audiologists

b. Speech, language, and hearing scientists

c. Speech-language pathologists

d. Professionals aides

10. The entry-level degree for an audiologist is currently

a. Bachelor’s degree in audiology

b. Master’s degree in audiology

c. Doctoral degree (AuD, PhD, or EdD in audiology)

d. Associate’s degree in audiology

11. The degree required for speech/language pathologists to earn the ASHA CCC is currently

a. Associate’s degree

b. Bachelor’s degree

c. Master’s degree

d. Bachelor’s degree plus a teaching certificate

12. Professional aides can

a. Work with supervision to assist audiolgists and SLPs

b. Conduct treatment independently

c. Conduct evaluations independently

d. Independently write all evaluation reports for the SLP or audiologist

13. Related professionals include

a. Occupational therapists

b. Physical therapists

c. Social workers

d. All of the above

14. On average,

a. 1 in 5 people has a disability

b. 1 in 10 people has a disability

c. 1 in 20 people has a disability

d. 1 in 50 people has a disability

15. Infants are screened for hearing loss and other disabilities

a. As soon as they are born

b. Within the first week of birth

c. Within the first month of birth

d. If they show signs of abnormal development

16. What do speech, language, and hearing scientists do?



16

17. Amost half of all SLPs are employed

a. In school systems

b. In healthcare

c. In private practice

d. All of the above combined

18. In addition to the entry-level degree, what else do audiologists need in terms of credentials?

19. School-age children with communication difficulties often experience

a. Academic difficulties

b. Social difficulties

c. Neither of the above

d. A & B

20. In addition to the entry-level degree, what else to SLPs need in terms of credentials?

21. How many Americans sustain a traumatic brain injury each year?

a. 500,000-750,000

b. 1.5-2 million

c. 2-4 million

d. None of the above

22. What are the assumptions of evidence-based practice?

23. Hearing loss may affect at least

a. 25% of older adults

b. 50% of older adults

c. 75% of older adults

d. Nearly all older adults

24. What is involved in clinical decision-making?

25. The best source(s) of clinical evidence is/are

a. Company websites

b. Magazine articles

c. Professional, peer-reviewed journals

d. All of the above

26. What are the three key elements of efficacy?

27. Efficacy is

a. The quickest and least effortful method resulting in the greatest positive benefit

b. The probability of benefit from an intervention under ideal conditions

c. Both of the above

d. Neither of the above



17

28. What are some factors that affect clinical decision making?

29. Effectiveness is

a. The quickest and least effortful method resulting in the greatest positive benefit

b. The probability of benefit from an intervention under ideal conditions


d. Neither of the above

30. Name and briefly describe four federal mandates affecting people with disabilities.

31. The first professional journal related to communication was called

a. The Voice

b. Speech Correction

c. Journal of the National Association of Teachers of Speech


32. _____________________ was the precursor to ASHA.

a. The National Education Association

b. The American Academy of Speech Correction

c. American Coalition of Citizens with Disabilities

d. The Education for All Handicapped Children Agency

33. Audiology became a profession in

a. The 1890s

b. The 1920s

c. The 1940s

d. The 1950s

34. Audiology experienced a boom in which decade due to WWII veterans who were experiencing noise-induced

hearing loss?

a. The 1910s

b. The 1920s

c. The 1940s

d. The 1950s



18

CHAPTER 1 – Answer key

THE FIELD, THE PROFESSIONALS, AND THE CLIENTS

1. D

2. A

3. B

4. C

5. D

6. B

7. C

8. B

9. B

10. C

11. C

12. A

13. D

14. A

15. A 16. Acceptable responses:

Speech scientists may be involved in basic research exploring anatomy, physiology, and physics of speech-

sound production

Investigate the causes, prevention, and treatment of various speech impairments

Development of computer-generated speech

Language scientists may investigate the ways children learn language

Conduct cross-cultural studies of language and communication

Study how languages are changing

Examine language disabilities and the nature of language disorders in children and adults

Hearing scientists investigate the nature of sound, noise, and hearing

They may help develop equipment for hearing assessment

Develop techniques for testing infants or those with physical or psychological impairments

Develop and improve assistive listening devices

Concerned with conservation of hearing and limiting environmental noise

17. A

18. In addition to the entry-level degree, what else do audiologists need in terms of credentials?

Educational requirements are 3-5 years of professional education beyond the bachelor’s degree

ASHA CCC-A: Requires doctorate, professional experience, national exam

State license is often needed and is frequently identical to ASHA CCC

19. D

20. In addition to the entry-level degree, what else to SLPs need in terms of credentials?

Public schools require at least a bachelor’s degree, but most states require a master’s degree. Requirements

vary from state to state.

ASHA CCC-SLP: Requires master’s degree or doctorate, professional experience, professional development,

national exam

State license often needed and is frequently identical to ASHA CCC. There may also be additional

requirements for the state’s department of education school certification



19

21. B

22. What are the assumptions of evidence-based practice?

Clinical skill grows from experience and current available data

The SLP or audiologist seeks new therapeutic information to improve efficacy

23. A

24. What is involved in clinical decision-making?

Combination of scientific evidence, clinical experience, and client needs

25. C

26. What are the three key elements of efficacy?

It refers to an identified population, not specific individuals

The treatment should be focused and the population should be clearly identified

The research should be conducted under optimal intervention conditions, although actual clinical conditions

may be less than ideal

27. B

28. What are some factors that affect clinical decision making?

Clinician’s expertise, experience, attitude, and motivation

Client/family values and characteristics

Service delivery variables

29. A

30. Name and briefly describe four federal mandates affecting people with disabilities.

1975: Education for All Handicapped Children Act (EAHCA) (Public Law 94-142): Mandated that a free and

appropriate public education (FAPE) must be provided for all handicapped children between ages 5 and 21.

1986: Education of the Handicapped Amendments (Public Law 99-457): Extended age of those served to

cover children between the ages of birth and 5 years.

1990: Individuals with Disabilities Act (IDEA): Addressed the multicultural nature of the U.S.

2004: Established birth to 6 programs as well as new early intervention services

31. A

32. B

33. B

34. C



20

CHAPTER 2

TYPICAL AND DISORDERED COMMUNICATION

1. Which of the following is the most accurate definition of the term 'communication'?

a. It is an exchange between senders and receivers.

b. It is another word for speech.

c. It is the process of self-expression.

d. It is the exclusively human quality to talk to other humans.

2. ____________________ is how cultural identity, setting, and participants influence communication.

a. Communication

b. Sociolinguistics

c. Psycholinguistics

d. Multiculturalism

3. Our cultural identity refers to

a. Our language

b. Our cultural communities



4. Grammar refers to

a. The rules of a language

b. The recognition by a native speaker of whether something is said “right” or “wrong”

c. Only the sound system of a language

d. The process of producing the acoustic representation of language

5. Linguistic intuition refers to

a. The rules of a language

b. The recognition by a native speaker of whether something is said “right” or “wrong”

c. The sound system of a language

d. Being born with the ability to produce language

6. What does it mean that languages are generative and dynamic?

7. What are the three primary components of language?

a. Phonology, morphology, syntax

b. Form, content, use

c. Semantics, syntax, pragmatics

d. Phonology, phonotactic rules, morphology

8. Form consists of

a. Phonology, morphology, syntax

b. Semantics, syntax, pragmatics

c. Phonology, phonotactic rules, morphology


9. Briefly explain how phonology and phontactic rules differ.



21

10. Briefly explain morphology, morphemes, free morphemes, and bound morphemes.

11. _____________________ is how words are arranged in a sentence and the ways in which one word may

affect another.

a. Syntax

b. Semantics

c. Morphology

d. Pragmatics

12. Content consists of

a. Syntax and semantics

b. Pragmatics

c. Semantics

d. Morphology and phonology

13. ______________ refers to the content or meaning of language, whereas _______________ refers to the

pieces of meaning that define a particular word

a. Morphemes, morphology

b. Morphology, morphemes

c. Semantic features, semantics

d. Semantics, semantic features

14. Use consists of

a. Syntax and semantics

b. Pragmatics

c. Semantics

d. Morphology and phonology

15. _________________ is how and why we use language; it varies with culture.

a. Syntax

b. Communication

c. Speech

d. Pragmatics

16. Speech consists of articulation and fluency. Briefly describe both.

17. Voice can reveal things about the speaker and the message. ______________ is a listener’s perception of how

high or low a sound is, ______________________ is the basic tone that an individual uses most of the time,

and ____________________ is the pitch movement within an utterance.

a. Habitual pitch, pitch, intonation

b. Intonation, pitch, habitual pitch

c. Pitch, intonation, habituatl pitch


18. About 2/3 of human meaning exchange is

a. Verbal

b. Vocal

c. Nonverbal

d. Nonvocal



22

19. ___________________ refer to how you look, your clothes, your possessions, music you listen to, etc.

a. Kinesics

b. Proxemics

c. Artifacts

d. Tactiles

20. __________________ refer to the way we move our body, or body language.

a. Kinesics

b. Proxemics

c. Artifacts

d. Tactiles

21. Briefly (in 6-10 sentences) explain communication through the lifespan. Be sure to touch on how infants

learn language, potential complicating factors, and how we end up being competent communicators.

22. __________________ refer to the physical distance between people as it affects communication.

a. Kinesics

b. Proxemics

c. Tactiles

d. Chronemics

23. __________________ refer to touching behaviors.

a. Kinesics

b. Proxemics

c. Tactiles

d. Chronemics

24. _________________ refer to the effect of time on communication.

a. Kinesics

b. Proxemics

c. Tactiles

d. Chronemics

25. ___________________ is the cause or origin of a problem, and may be used to classify a communication

problem.

a. Dialect

b. Etiology

c. Congenital disorder


26. _____________________ disorders are present at birth, whereas _____________________ disorders are the

result of illness, accident, or environmental circumstances later in life.

a. Etiological, dialectal

b. Genetic, accidental

c. Congenital, acquired

d. Primary, secondary

27. Briefly describe disorders of form and potential etiologies.



23

28. Briefly describe disorders of content and potential etiologies.

29. Briefly describe disorders of use and potential etiologies.

30. ______________________ is a speech disorder caused by paralysis, weakness, or poor coordination of the

speech musculature.

a. Dysarthria

b. Apraxia

c. Dysphagia

d. Stuttering

31. _____________________ is a speech disorder that is due to neuromotor programming difficulties.

a. Dysarthria

b. Dysphagia

c. Aphasia

d. Apraxia

32. In disorders of ______________, the smooth, uninterrupted flow of speech is affected.

a. Articulation

b. Voice

c. Language

d. Fluency

33. Provide examples of the following: Fillers, hesitations, repetitions, and prolongations.

34. What is stuttering?

35. What are some habits that can affect normal voice production? What are other causes?

36. ___________________ is the term for excessive yelling, screaming, or loud singing. Can result in hoarseness

or another voice disorder.

a. Vocal hygiene

b. Vocal abuse

c. Vocal strain

d. Vocal exertion

37. What is deafness?

38. Name three interventions for deafness.

39. What are the ways in which hearing loss can be categorized?



24

40. A hearing loss that is caused by damage to the outer or middle ear.

a. Conductive

b. Sensorineural

c. Mixed


41. A hearing loss that is due to problems with the inner ear and/or auditory nerve.

a. Conductive

b. Sensorineural

c. Mixed


42. Describe auditory processing disorders. Include symptoms, etiology, and population affected.

43. Explain the following phrase: “Communication disorders are often secondary to other disabilities.” Give

examples.

44. _____________________ is the number/percentage of people within a specified population who have a

particular disorder or condition at a given point in time.

a. Incidence

b. Prevalence

c. Impaired population


45. What percentage of the U.S. population has a communication disorder?

a. 1%

b. 4%

c. 9%

d. 17%

46. Impairments of speech-sounds and fluency are more common in ________ than _________ and more

common in __________ than ___________.

a. Children, adults, males, females

b. Adults, children, males, females

c. Children, adults, females, males

d. Adults, children, females, males

47. Describe the process of communication disorders assessment.

48. ____________________ distinguish(es) an individual’s difficulties from the broad range of possible

problems.

a. Etiological factors

b. Genetic markers

c. Predisposing causes

d. Diagnosis



25

49. _________________________ refers to working with a client for a time to obtain a clearer picture of

strengths and weaknesses.

a. Response to intervention

b. Constraint-induced therapy

c. Diagnostic therapy

d. The cycles approach

50. A prognosis is

a. An informed prediction of an outcome

b. A trigger for a disorder

c. A factor that continues or adds to a problem


51. _________________________ tests yield scores that are used to compare a client with a sample of similar

individuals.

a. Dynamic assessment

b. Criterion referenced

c. Norm-referenced

d. All of the above

52. _________________________ tests evaluate a client’s strengths and weaknesses with regard to particular

skills.

a. Dynamic assessment

b. Criterion referenced

c. Norm-referenced


53. Name factors that influence intervention.

54. What are five objectives of intervention?

55. Baseline data is

a. A measurement of the client’s accuracy before beginning intervention

b. The data from a normative sample

c. Test scores from norm-referenced tests


56. What is the A, B, C, and D of behavioral objectives?

57. Behavior modification includes

a. Behavior and rewards

b. Stimulus and reinforcement

c. Extinguishing and punishing




26

58. In incidental teaching,

a. The SLP provides a stimulus and reinforces the response if it is correct

b. The parent is responsible for providing therapeutic intervention after instruction

c. The SLP follows the client’s lead and teaches along the way

d. The child is encouraged to learn language skills from other children in the environment

59. What are the functions of support groups for communication disorders?

60. If therapy has been effective, the client is successful in

a. Generalizing the learned skills

b. Self-correcting

c. Experiencing automaticity

d. All of the above

61. Briefly describe the follow-up and maintenance process.



27

CHAPTER 2 – Answer key

TYPICAL AND DISORDERED COMMUNICATION

1. A

2. B

3. C

4. A

5. B

6. What does it mean that languages are generative and dynamic?

Generative means that each utterance is freshly created

Dynamic means that languages change over time

7. B

8. A

9. Briefly explain how phonology and phontactic rules differ.

Phonology is the sound system of a language, whereas phonotactic rules specify how sounds may be arranged

in words.

10. Briefly explain morphology, morphemes, free morphemes, and bound morphemes.

Morphology involves the structure of words

Morphemes are the smallest grammatical units of a language

Free morphemes may stand alone as words

Bound morphemes change the meaning of the original words and can only be attached to free morphemes

11. A

12. C

13. D

14. B

15. D

16. Speech consists of articulation and fluency. Briefly describe both.

Articulation is the way speech sounds are formed. Fluency is the smooth, forward flow of communication,

influenced by rhythm and rate. Rate is the speed at which we talk. Rate and rhythm are both components of

prosody.

17. D

18. C

19. C

20. A



28

21. Briefly (in 6-10 sentences) explain communication through the lifespan. Be sure to touch on how infants

learn language, potential complicating factors, and how we end up being competent communicators.

Infants must first learn the rudiments of communication and begin to master speech. The early establishment

of communication between children and caregivers fosters the development of speech and language, which

influence the quality of communication. This is complicated by physical, cognitive, and social development.

The key to becoming a communicator is being treated as one. The process of learning speech and language is

a social one that occurs through interactions of children and the people in their environment. Every person’s

speech and language continues to change until the end of life. A competent communicator continues to adapt

to changes in the language and in the communication process.

22. B

23. C

24. D

25. B

26. C

27. Briefly describe disorders of form and potential etiologies.

Errors in sound use constitute a disorder of phonology.

Incorrect use of past tense or plural markers is an example of a disorder of morphology

Syntactical errors include incorrect word order and run-on sentences

May be due to sensory limitations, perceptual difficulties, limited exposure to correct models, etc.

28. Briefly describe disorders of content and potential etiologies.

Limited vocabulary, misuse of words, or word-finding problems

Difficulty understanding and using abstract language

May be due to limited experience, concrete learning style, strokes, head trauma, or certain illnesses.

29. Briefly describe disorders of use and potential etiologies.

Pragmatic impairments may stem from limited or unacceptable conversational, social, and narrative skills;

deficits in spoken vocabulary; and/or immature or disordered phonology, morphology, and syntax

Might include difficulty staying on topic, providing inappropriate or incongruent responses to questions, or

continually interrupting the conversational partner.

30. A

31. D

32. D

33. Provide examples of the following: Fillers, hesitations, repetitions, and prolongations.

Fillers: “er,” “um,” “ya know”

Hesitations: unexpected pauses

Repetitions: “g-g-g-go”

Prolongations: “wwwwwwell”

34. What is stuttering?

When these speech behaviors (fillers, hesitations, repetitions, prolongations) exceed or are qualitatively

different from the norm or are accompanied by excessive tension, struggle, and fear.

35. What are some habits that can affect normal voice production? What are other causes?

Physical tension, coughing, throat clearing, smoking, and drinking alcohol

Disease, trauma, allergies, neuromuscular disorders, endocrine disorders



29

36. B

37. What is deafness?

When a person’s ability to perceive sound is limited to such an extent that the auditory channel is not the

primary sensory input for communication. It may be congenital or acquired.

38. Name three interventions for deafness.

Three of the following: Total communication, assistive listening devices, cochlear implants, auditory training

39. What are the ways in which hearing loss can be categorized?

Temporary or permanent

In terms of severity, laterality, and type

Severity may range from mild to severe (or profound)

The loss can be bilateral or unilateral

The type of loss can be conductive, sensorineural, or mixed

40. A

41. B

42. Describe auditory processing disorders. Include symptoms, etiology, and population affected.

Individuals with APD may have normal hearing but difficulty understanding speech.

Difficulty keeping up with conversation, understanding speech in noise, discriminating and identifying

speech sounds, and integrating speech with nonverbals.

Etiology is often unknown, but can be due to tumor, disease, or brain injury.

Can occur in children or adults.

May coexist with other disorders.

43. Explain the following phrase: “Communication disorders are often secondary to other disabilities.” Give

examples.

Children or adults may have a disorder that causes a communication disorder. For example, children with

cleft palate (primary) often have communication impairments associated with the cleft. Individuals with

cerebral palsy (primary) often have difficulty in various areas of speech.

44. B

45. D

46. A

47. Describe the process of communication disorders assessment.

Systematic process of obtaining information from many sources, through various means, and in different

settings to verify and specify communication strengths and weaknesses, identify possible causes of problems,

and make plans to address them.

48. D

49. C

50. A

51. C

52. B

53. Name factors that influence intervention.

Nature and severity of the disorder, the age and status of the client, environmental considerations, and

personal/cultural characteristics of the client and clinician.



30

54. What are five objectives of intervention?

The client should show improvement and this should generalize

What has been learned should be largely automatic

The client must be able to self-monitor

The client should make optimum progress in the minimum amount of time

Intervention should be sensitive to the personal and cultural characteristics of the client

55. A

56. What is the A, B, C, and D of behavioral objectives?

Actor: Who is expected to do the behavior?

Behavior: What is the observable and measurable behavior?

Condition: What is the context or condition of the behavior?

Degree: What is the targeted degree of success?

57. B

58. C

59. What are the functions of support groups for communication disorders?

They can provide an avenue to practice what has been learned in therapy, share feelings about the disability,

and maintain communication skills once formal treatment has been terminated.

60. D

61. Briefly describe the follow-up and maintenance process.

Upon dismissal, the client or family should be encouraged to return if there is a need. A regular follow-up

schedule can be established. Booster treatment may be provided if needed.



introduction to communication disorders: a lifespan ... · pdf fileintroduction to...

Documents