movement of nostrils during speech

difficulty blowing, whistling, & gargling

spilling of liq thru nose

lip pits

bilateral complete cleft lip and palate

incomplete cleft palate

horseshoe palate

1. Cleft of soft palate only
2. cleft of hard and soft palate to incisive foramen
3. complete unilateral cleft of the soft & hard palate and of lip & alveolar ridge on 1 side
4. Complete bilateral cleft of soft & hard palate and/or the lip & alveolar ridge on both sides

• cleft lip: 3-6 mo
• cleft palate: 12-18 mo
• alveolar bone graft: 6-10 yrs
• plastic surgery: adolescence to maturity of growth

• speech bulb
• palatal lift

• pharyngeal flap
• sphincter pharyngoplasty

1. BICS: basic interpersonal communication skills
2. CALP: cognitive academic lang proficiency

• replaces speech with gestures
• gives inappropriate responses
• poor topic maintanance
• difficulty turn-taking
• echoes what is heard
• etc

1. Briefing
2. Interaction
3. Debriefing

• enhance or facilitate comm for individuals with severe expressive comm disorders
• increase social interaction, school perf & feelings of self-worth

1. symbols
2. aids
3. techniques
4. strategies

• Aided: communication boards with visual graphics (PEAT)
• Unaided: nonverbal means of comm (ASL)

1. verbal apraxia
2. oral-facial apraxia
3. limb-kinetic apraxia

• Acquired: identified brain lesion (TBI, CVA)
• Developmental: damage occured before onset of speech development

1. Test for aphasia first

(Aphasia tests eval:

artic agility, melodic line of phonemic difficulties, oral nonverbal skills, ex:Boston Diag Aphasia Exam)

2. If mtr impairment discovered, then test for apraxia

Apraxia Battery for Adults

Motor Speech Evaluation

• localization of the lesion site to 3rd frontal convolution
• the prescence of hemiplegia

Apraxia: relatively normal auditory comp when compared to difficulties w/ oral expression appears "fluent"

Aphasia: experience difficulties with comprehension & use of language

• distinct speech patterns
• muscle weakness, slowness & incoordination
• affected oral mvmts reflect neuropath affected
• vegetative fxnx are impaired
• consistent errors

• artic errors
• NO muscle weakness, slowness or incoord
• cortical programming for voluntary speech production impaired
• vegetative fxns are NOT affected
• inconsistent errors

• communicaiton impairment
• repetitive patterns of behavior, interests and activities
• delayed or abnormal fxning in: social interaxn, lang used in social comm, symbolic or imaginative play before age of 3

• "high-functioning autism"
• normal lang and cognitive development
• normal adaptive behavior
• impairment in social interaxn
• repetitive patterns of behavior, interests & activities

• occurs more often in females
• normal development until 5-48 mths, until a progressive deterioration causes:
• a deceleration in head circumference,
• hand-wringing,
• poor mtr coordination for walking
• speech lang disorder

• atypical development
• difficulties w/ left hemisphere fxns
• stereotypical behavior (body rocking)
• egocentric
• hyoersensitive hearing
• fine mtr developmental delays
• avoids eye contact- prefers being alone
• echolalia

ASD affects an estimated..

hypernasality and/or nasal emission

when there is a poor velopharyngeal mvmt due to a physiological cause

due to: neuromuscular or

structural deficits (submucous cleft)

Hypernasality- during production of vowels

Nasal emission- during production of nasal consonants

• not enough sound resonating in the nasal cavity during speech
• too little air escaping thru the nose (stuffy nose talk)

a swallowing disorder in which one has difficulty:

swallowing liquids

chewing food

sucking

• neurological conditions (stroke, TBI)
• head & neck cancer
• vocal fold paralysis
• conditions of upper aerodigestive tract
• prematurity/low birth weight
• cleft lip / palate

1. Oral preparatory stage: chewed -bolus
2. Oral phase: bolus moved to back of mouth
3. Pharyngeal phase: food guided past airway
4. Esophageal phase: bolus enters esophagus

• info gathering
• oral mech exam
• trial swallows
• view swallowing fxn

1. Modified Barium Swallow (MBS)
2. Fiber-Endoscopic Examination of Swallowing (FEES)

Alaryngeal speech possibilities (3)

1. Esophageal speech
2. Tracheoesophageal speech
3. mechanical / artificial speech

What is a psychometric test?

any standardized procedure for measuring sensitivity, memory, intelligence, aptitude or personality

"test was standardized on large sample of students"

1. construction of instruments and procedures for measurement
2. development and refinement of theoretical approaches to measurement

validity; test measures what its supposed to measure

Concurrent validity: score on test able to measure similarly to score of another test in related area

Predictive validity: score on test able to estimate scoring on a "criterion measure" @ a future time.

1. test-retest
2. split half
3. alternate form
4. rater

most frequently used measure when comparing the individual to the normative group

(usually 100)

more interpretable measure of variation

(SD = 15) (bet. 85-115)

• raw score
• percentile rank
• standard score (Z-score, T-score)
• Stanine

percentage of subjects  or scores that fall at or below a particular raw score

(below 16 is below average)

conversion of raw score

2.5 and below is clinically significant

range of scores witha high probability of including the "true" score __% of the time.

(68%, 90% or 95%)

true positive

accurately ID a disorder

(Sensitivity)

people who don't have a disorder pass the test

(Specificity)