Communication Science and Disorders
Terms
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- incidence and prevalence of stuttering
- 1% stutter at the moment, 5% have stuttered at some point for 6 months or more; 3:1 ration of males to females
- Afferent Neuron
- a neuron conducting impulses inwards to the brain or spinal cord
- primary stuttering behaviors
- the dysfluencies (common to most people): repetitions, prolongations [of a sound], interjections; block (not common to most people): a silent prolongation for 1-2 seconds, feel like they're stuck,
- cancellation
- stop as soon as a stuttered word is complete, pause, then say word again in an "easy" way
- Gyri
- elevated ridges of brain tissue, separated by shallow grooves called sulci
- congenital palatopharyngeal incompetence
- no cleft, but can't close velopharyngeal port, short palate, deep pharynx,
- Ventricles
- cavities within the brain (4)
- Orthopedic Classification
- limbs affected: monoplegia (one limb), paraplegia (both legs), triplegia (three limbs), quadriplegia (four limbs)
- measure stuttering
- total number of words with within-word dysfluencies/total number of words times 100 for frequency
- Sulci
- shallow grooves that separate gyri
- Peripheral Nervous System
- cranial nerves, spinal nerves
- Meninges
- three membranes that cover the brain and spinal cord, consisting of the dura mater, pia mater, and arachnoid mater
- Distinctive features
- all sounds have different features
- Inhale procedure
- air enters, ribcage moves out, lungs expand, diaphragm moves down
- Scapula
- Shoulder Blade
- vowels
- narrowing of vocal cavity, degree of constriction, lip rounding
- muscles of exhalation
- rectus abdominis, internal intercostals
- Cleft Palate Causes
- failure of disruption / development during 3rd month gestation; hereditary, environment (teratogenic agents, stress, medications, infections, substances)
- Right Hemisphere
- Wholistic functioning
- Fluency Shaping
- train a slower speech rate, relaxed breathing, easy initiation of sounds, smoother transition between words
- Dendrites
- receive neural stimuli from other neurons and receptors
- Fluency
- speech that is easy, rapid, rhythmical, flowing
- Frequency of Phonation
- vibration frequency; determined by the mass and tension of the vocal folds; increased tension when folds are stretched, think of rubber band that's stretched and plucked (how high is frequency?)
- adduction
- when vocal folds are brought together
- Myelin
- a whitish, waxy and fatty material that covers most nerve fibers
- preparatory sets
- anticipate stuttering on certain sound or word and form a preparatory set to "ease" into the word
- Extrapyramidal tract
- pathway that helps with control of movement
- Axon
- long fiber that conducts nerve impulses away from cell body (may be as long as 1 meter or a few micrometers)
- Cleft Lip Surgery
- are usually repaired within first three months (cheiloplasty)
- dysarthria
- a neuromuscular dysfunction of speech; damage to central and/or peripheral nervous system pathways causing muscle dysfunction; causes muscle weakness, muscle incoordination, paralysis of muscles
- Arytenoid
- at top and back of cricoid are pyramid-shaped arytenoid cartilages, lie in concave indentations on cricoid, anchored by ligaments
- expiration (exhalation)
- reduction in lung volume, causes in increase in air pressure in the lungs, with an outward flow of air
- Broca's area
- program speech movements for speech production; language formulation
- coarticulation
- sounds are not produced in isolation; the anticipation of upcoming sounds to be produced; overlapping of articulatory movements
- Synapse
- the junction between the axon tip of the sending neuron and the dendrite of the receiving neuron
- Left Hemisphere
- Sequential hemisphere
- pull-outs
- ease out of repetitions, prolongations, and blocks
- Nucleus
- a cell's central control system (like the cell's brain)
- speech breathing
- lungs are increased to larger volume; longer expiratory phases
- cricoid
- shaped like a signet ring, located at top of trachea, larger in back than front
- Effects of cleft lip / palate
- doesn't affect speech unless alveolar ridge is involved, resonance problems with vowels if air ends up in nasal cavity, social and parental interactions / concerns, feeding, speech, dental
- Secondary Stuttering Behaviors
- counterproductive adaptations made by people who stutter as they try to get through primary stuttering behaviors or try to avoid those behaviors: blinking eyes, opening jaws, pursing lips, changing words, flapping arms (become more distracting than primary stuttering behaviors)
- Trachea
- made up by a series of cartilage rings extending from larynx to bronchi of lungs
- consonants
- place of constriction, manner of constriction, voicing
- Efferent Neuron
- carries motor info to the muscles and glands ( brain telling body what to do)
- development of stuttering
- early development (7% of world are somewhat dysfluent), genetic influences (3 x greater for person with first degree family member who also does this), environmental demands and capacity for fluency (if 2 parents are in a hurry to go somewhere, child might perceive pressure to talk faster than his motor speech capabilities will allow...child begins to associate storytelling with dysfluency)
- Cleft Lip and Palate incidence and frequency across ethnicities
- 1 out of 750 live births; most frequent to least frequent: Native Americans, Asians, Caucasians, African Americans
- superior sphincter pharyngoplasty
- secondary surgery for cleft palate - segments of muscle added to area of closure
- Diaphragm
- bowl-shaped partition between lungs and abdominal contents
- Mandible
- Jaw; largest mass of any articulator; serves as platform for tongue; lowers or raises tongue depending on height of vowel;
- Brainstem
- location where sensory information from body receptors comes in via nerves (touch, temperature, pain, pressure, vision, hearing, balance); also where cranial nerves leave to go out to muscles
- vocal tract composed of
- (made up of series of interconnected tubes) oral cavity, nasal cavity, pharynx
- quiet breathing
- 15-18 breaths per minute
- Brain Hemispheres
- left hemisphere, right hemisphere, Brodmann areas
- Law of Gases
- air flows from areas of high pressure to areas of low pressure
- Cleft Palate Surgery
- typically repaired at around 12 months of age; called primary palatoplasty (about 80-90% who have this procedure will have adequate velopharyngeal closure)
- dysarthria differences between children and adults
- children: most frequently associated with cerebral palsy; adults: most frequently arises from cerebrovascular or progressive neurological disease
- Voice Problems with Cleft
- hypernasality (nasal emission), hoarseness (straining voice), cul-de-sac resonance ( front of nose blocked)
- Vocal Folds
- two pairs (false and true), notch below adam's apple, phonates on and off
- pharyngeal flap surgery
- secondary surgery for cleft palate - create flap of tissue attached to back wall of throat with other end sutured to soft palate
- Nasal Cavity
- to cleanse, warm, and humidify air passing through it during inspiration;
- Intensity of Phonation
- determined by force with which air escapes through the glottis; and strikes air mass in vocal tract above the vocal folds; determined by amount of subglottal pressure, greater the pressure, the greater the movement of vocal folds, greater the amount of air escaping through glottis, the louder the sound
- Dysfluency examples
- describes speech that is marked by repetitions, interjections, pauses, and revisions
- fundamental frequency
- equal to the frequency of the vibration of the focal folds
- abduction
- when vocal folds come apart
- clavicle
- collarbone
- true vocal folds
- composed of tissue layer and vocalis muscle, extend from arytenoid cartilages in back to the point just below thyroid cartilage in front
- oral cavity
- from lips to back of throat
- false vocal folds
- lie above true vocal folds, closed during heavy lifting
- Ribs
- lungs surrounded by 12 pairs; 7 pairs attach to sternum; 3 pairs attach to cartilage at base of sternum; 2 "floating ribs" - don't touch sternum
- Bernoulli Effect
- reduction of air pressure with increases in air flow, as air rushes into opening created by fold movement, the air pressure is reduced between folds, folds are sucked back together
- hard palate
- inverted bowl-shaped; contact point for tongue; important for multiple sounds
- Communication Problems with Cleft
- language development problems (syndrome, psychosocial issues); hearing problems (middle ear disease and eustachian tube problems)
- External Intercostals
- sheet of 11 muscles lie between the ribs
- suprasegmentals
- aspects of motor speech programming that are longer/bigger than individual sounds (stress, intonation, rhythm)
- Alveolar Ridge
- bony semicircular shelf of the upper jaw (important for sounds like /t/ /d/ /s/ /z/)
- Speech Problems with Cleft
- Articulation Problems (problems with plosives, fricatives, and affricates), compensatory articulation (substitution of glottal and pharyngeal sounds for sounds they are trying to produce)
- passive recoil of exhalation
- when it is moved to a larger or smaller volume, a "force" is stored that will try to return it to rest position
- velopharynx
- opening [flap] between nose and mouth where oral and nasal cavities are joined
- Articulation disorder
- Phonetic errors, Problems in speech sound production, Difficulties w/ speech sound form, Disturbance in relatively peripheral motor processes, Production does not typically impact other language areas
- Cleft Lip / Palate Prostheses
- artificial substitutes for missing or deficient parts (speech bulbs - inadequacy; palatal lift - incompetency)
- Pyramidal Tract
- direct pathway from cortical surface to the peripheral nerves
- Arcata Fasciculus
- connects Wernicke's to Broca's area
- velopharyngeal port
- helps produce nasal and oral sounds (closed during oral sounds)
- Motor Pathways
- Pyramidal Tract, extrapyramidal tract
- Stuttering modification
- help person who stutters to acquire a speech style they find acceptable (motivation, identification, desensitization, variation, approximation, stabilization)
- assessment process overview
- spontaneous speech and language sample, articulation tests (single word and sentence tests), analysis of speech samples, oral-peripheral examination (oral mechanism exam)
- phonological treatment
- may teach / emphasize more linguistic principles
- Cortex
- Outer Surface of Brain (covered with gyri and sulci)
- how folds vibrate
- open first at bottom of folds, opening progresses upward to the top, as they are blown apart, they move up and to the side, then brought back together again because they are elastic and return to their original state, also because of the Bernoulli effect
- Tidal Volume
- volume of air exchanged during a task; during quiet breathing, it's about 500 millileters of air that you inspire and expire
- mobile articulators
- jaw, tongue, face, velopharyngeal port
- pharynx divided into
- nasopharynx, oropharynx, laryngopharynx
- Alveoli
- place where oxygen and carbon dioxide are exchanged during breathing (air filled sacs)
- Wernicke's area
- language interpretation
- factors related to cause of stuttering
- stuttering resolves in 60-80% of people who stutter during childhood
- larynx Functions
- vocal folds within vibrate to create a voice; keeps food from entering the lungs; also vocal folds anchor thorax during heavy lifting or load bearing
- phonological processes
- variations in the way phonemes are combined
- Voicing
- all vowels, diphthongs, nasals are voiced; fricatives, stops, affricates may be voiced or unvoiced
- cause of stuttering
- internal (inherited traits, temperament, cognitive abilities, language knowledge, information processing mechanisms (attention, perception, memory), speech motor control; external factors (culture, parental expectations, childrearing practices, educational experiences, relationships with siblings and peers)
- glottis
- space between true folds (vocal folds)
- Cerebral Palsy
- a syndrome of deficits in visual, auditory, intellectual or motor functions in critical early development period
- Phonological Disorders
- Phonemic errors, Problems in language fx of phonemes, Difficulties w/ phoneme fx, Disturbance is impairment of representation/organization of phoneme within language system, Production may impact other language areas
- differences among people who stutter
- not all people who stutter do so in the same way and with the same frequency; worse when people pressure themselves to be fluent;
- stuttering
- when speech is interrupted by an unusually high frequency or duration of repititions, prolongations, blockages; when interruptions to speech are combined with excessive mental and physical effort to resume talking, when they have negative perceptions of their communication abilities
- teeth
- embedded in the alveolar ridge of maxilla [upper jaw]
- Thyroid
- at front of neck, single, butterfly-shaped thyroid cartilage, articulates [touches] the cricoid cartilage with horns called cornu, another set of horns (cornu) extend upward from body of thyroid to approximate the hyoid bone
- orbicularis oris
- tear-shaped muscle forming interior or upper and lower lip in a circle, functions to open, close, round, retract the mouth, important for consonants and vowels
- neuromuscular classification system
- spastic (resistance to muscle lengthening), athetoid (involuntary movements), ataxic (problems with coordination, speed, accuracy, rhythm)
- articulation treatment
- teach motor learning principles
- Boyle's Law
- The relationship between the pressure and volume of a gas; when volume increases, pressure decreases
- Severity Classification
- how independent in communication, ambulation, and self-help skills: mild (no need for help), moderate (speech is impaired, treatment is needed), severe
- Cerebellum
- the "little brain" attached to the rear of the brainstem; it helps coordinate voluntary movement and balance
- Lungs
- lie within the bony thorax; access upper airway via the trachea
- Central Nervous System
- Brain, Spinal Cord
- Cleft Palate major types
- cleft of lip only: 25%; cleft of palate only: 25%; cleft of lip and palate: 50%
- dysarthria affects...
- respiration, phonation, articulation, resonance
- Synaptic Cleft
- a tiny gap that seperates each axon terminal from the next neuron (neuronal kiss)
- nasal cavity
- from the opening of the nostrils [nares] to the velopharynx
- differences between people who stutter and people who don't stutter
- more negative concepts of themselves as speakers, subtle differences in language abilities, may use their brains differently during speech
- Exhale procedure
- diaphragm moves up, lungs get smaller, ribcage moves down and in, air leaves
- cartilages of larynx
- cricoid, arytenoids, thyroid
- fixed articulators
- teeth, alveolar ridge, hard palate
- larynx
- purpose is to convert respiratory energy into sound energy (phonation)
- Submucous Cleft Palate
- one child in 1200, no obvious sign of cleft, cleft present under mucous lining of palate
- Brainstem consists of...
- midbrain, pons, medulla
- source-filter theory
- vocal tract as resonator
- inspiration (inhalation)
- an increase in lung volume, causes a reduction in air pressure within the lungs, with an inward flow or air
- Articulation
- the process of forming speech sounds by movement of the articulators to produce speech sounds
- muscles of inspiration
- diaphragm, external intercostals
- rectus abdominis
- muscle that pushes inward on abdominal contents
- Broddman's area
- Broca's area, Wernicke's area
- Lobes
- Frontal, Parietal, Temporal, Occipital
- Internal Intercostals
- series of muscles between ribs (pull down on ribcage )
- incisors
- (teeth) important for sounds like voiced and voiceless /th/, /f/ and /v/
- pharynx
- portion of the vocal tract extending from the vocal folds to the nasal cavity