Inc. PRO-ED, · Fundamentals of Resonation 15 Fundamentals ofArticulation 17 Neuroanatomy and Neurophysiology: ... language Development in Children 105 . Terms and Definitions 105

Contents

Preface xix

CI:iAPTER 1

Anatomy, Neuroanatomy, and Physiology of the Speech Mechanism 1

Respiration: Structures and Processes 1 Respiration Patterns During Speech Production 1

Framework of Respiration 2

Muscles of Respiration 6

Phonation: Structures and Processes 8 Larynx 8

Laryngeal Structures and Cartilages 9

Intrinsic Laryngeal Muscles 10

Extrinsic Laryngeal Muscles 12

Vocal Folds 12

Physiology of Phonation 13

Neuroanatomy of the Vocal Mechanism 14

Resonation and Articulation: Structures and Processes 15 Fundamentals of Resonation 15

Fundamentals ofArticulation 17

Neuroanatomy and Neurophysiology: The Nervous System 28

Neurons and Neural Transmission 28 Anatomy and Physiology ofNerve Cells 28

The Peripheral and Autonomic Nervous Systems 31 Peripheral Nervous System 31

Autonomic Nervous System 38

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The Central Nervous System 40 Basic Principles 41 The Brainstem 41 Reticular Activating System 43

Diencephalon 43

Basal Ganglia 44 The Cerebellum 45 The Cerebrum 46

Pyramidal System 51

Extrapyramidal System 54 Connecting Fibers in the Brain 55 The Cerebral Ventricles 56 Protective Layers of the Brain 57

Cerebral Blood Supply 57

Chapter Highlights 61

Study and Review Questions 62

References and Recommended Readings 66

Study and Review Answers 66

CHAPTER 2

Physiological and Acoustic Phonetics: A Speech Science Foundation 69

Basic Principles and Definitions 69 Definitions 70

Anatomy and Physiology: A Brief Review 71

Phonetic Transcription 72 The International Phonetic Alphabet 72

Broad Phonetic Transcription 72 Narrow Phonetic Transcription 72

Production of Segmentals: Consonants and Vowels 7S Consonants and Vowels: The Syllable as a Unit 75 Classification Systems 76

Consonants 78

Vowels 84

The Effects of Context in Speech Sound Production 88 Dynamics of Speech Production 88

Suprasegmentals 88

Speech Science: Physiological Phonetics, Acoustic Phonetics, and Speech Perception 90 Acoustics: Basic Definitions 90

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Introduction to the Study of Sound and Acoustic Analysis of Speech 92 Sound Wave Generation and Propagation 93

Frequency and Pitch 93

Amplitude and Loudness 94

Sound Pressure Level and Hearing Level 94

Introduction to the Acoustic Analysis ofSpeech 95





CHAPTER 3

language Development in Children 105

Terms and Definitions 105 Morphology 106

Syntax 107

Semantics 108

Pragmatics 109

Normal Language Development: Developmental Milestones 111 Role of the Caregiver in Language Development 111

Birth to 1 Year 112

1-2 Years 114

2-3 Years 117

3-4 Years 118

4-5 Years 121

5-6 Years 123

6-7 Years 125

7-8 Years 126

Development ofLiteracy Milestones 127

Language Development and Education in the School-Age Years 127

Theories of Language Development 128 Behavioral Theory 129

Nativist Theory 130

Cognitive Theory 132

Information -Processing Theory 134

Social Interactionism Theory 136



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CHAPTER 4

Language Disorders in Children 149

Introduction to Children with language Disorders 149 Description of Language Disorders in Children 150

Risk Factors for Language Disorders in Children 150

Children with Specific language Impairment 151 Characteristics of Children with Specific Language Impairment 151

Children with language Problems Associated with Physical and Sensory Disabilities 153 Intellectual Disabilities 154

Autism Spectrum Disorders 155

Brain Injury 157

Children with language Problems Related to Physical and Social-Environmental Factors 160 Language Problems Related to Poverty 160

Language Problems Related to Neglect or Abuse 161

Language Problems Related to Parental Drug and Alcohol Abuse 162

Language Problems Related to Attention-Deficit/Hyperactivity Disorder 164

Assessment Principles and Procedures 166 Language Assessment: General Principles and Procedures 166

Assessment of Infants and Toddlers 169

Assessment of Preschool and Elementary-Age Children 172

Assessment of Adolescents 176

Treatment Principles and Procedures 182 General Principles 183

Specific Techniques and Programs 184

Augmentative and Alternative Communication 190





CHAPTER 5

Articulatory-Phonological Development and Speech Sound Disorders 207

Foundations of Articulation and Phonology 207 Basic Definitions 208

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Distinctive Features Paradigm 209

Place-Voice-Manner Paradigm 209

Acquisition of Articulatory and Phonological Skills: Typical Development 211 Theories of Development 211

Infant Development: Perception and Production 214

Typical Articulation Development in Children 215

Typical Phonological Development in Children 217

Speech Sound Disorders 219 General Factors Related to Speech Sound Disorders 219

Description ofArticulatory Errors 220

Organically Based Disorders 221

Assessment of Speech Sound Disorders 225 Screening 226

General Assessment Objectives 226

Related Assessment Objectives 226

Assessment Procedures 227

Specific Components of an Assessment 228

Scoring and Analysis ofAssessment Data 230

Treatment of Speech Sound Disorders 232 General Considerations in Treatment 232

Motor-Based Approaches 233

Linguistic Approaches 235

Phonological Awareness Treatment 238

Adults Who Speak English as a Foreign language 239 Principles ofAssessment 239

Principles ofAccent Training 240





CHAPTER 6

Fluency and Its Disorders 253

Fluency and Stuttering: An Overview 253 Definition and Description of Fluency 254

Definition and Description of Stuttering 254

Forms of Dysfluencies 257

Theoretical and Clinical Significance of Dysfluencies 258

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Incidence and Prevalence of Stuttering 258

Onset and Development of Stuttering 261

Associated Motor Behaviors 262

Associated Breathing Abnormalities 262

Negative Emotions and Avoidance Behaviors 263

The Loci of Stuttering 263

Stimulus Control in Stuttering 264

People Who Stutter and Their Families 266

Theories of Stuttering 267

Assessment and Treatment of Stuttering 272 Assessment of Stuttering 272

Treatment of Stuttering 274

Neurogenic Stuttering 279 Definition and Etiology of Neurogenic Stuttering 279

Description of Neurogenic Stuttering 280

Assessment and Treatment of Neurogenic Stuttering 280

Cluttering 281 Definition and Description of Cluttering 281

Assessment and Treatment of Cluttering 282





CHAPTER 7

Voice and Its Disorders 291

Vocal Anatomy and Physiology 291 The Larynx 291

Voice Changes Through the Life Span 296

Vocal Pitch, Volume, and Quality 297 Pitch 298

Volume 298

Quality 298

Evaluation of Voice Disorders 300 Case History: Purposes and Goals 301

A Team-Oriented Approach 301

Instrumental Evaluation 301

Perceptual Evaluation 306

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Disorders of Resonance and Their Treatment 309 Hypernasality 310

Hyponasality 310 Assimilative Nasality 311

Cul-de-Sac Resonance 311

Treatment Principles 312

Disorders of Phonation and Their Treatment 313 Carcinoma and Laryngectomy 313 Physically and Neurologically Based Disorders of Phonation 317

Abuse-Based Disorders of Phonation 326

Disorders of Loudness and Pitch 332

Psychogenic Voice Disorders 334

Gender Issues and the Voice 335





CHAPTER 8

Neurologically Based Communicative Disorders and Dysphagia 347

Aphasia 347 Foundational Concepts 348

Definition and Classification ofAphasia 348

Nonfluent Aphasias 349

Fluent Aphasias 351

Subcortical Aphasia 354 Aphasia in Bilingual Populations 355

Aphasia in Left-Handed Individuals 356

Assessment of Aphasia 356 Treatment ofAphasia 360

Alexia, Agraphia, and Agnosia 363

Apraxia of Speech 364 Definition and Distinctions 365

Neuropathology ofAOS 365

General Symptoms ofAOS 365

Communication Deficits in AOS 366

Assessment ofAOS 367

Treatment ofAOS 368

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The Dysarthrias 369 Definition of the Dysarthrias 369

Neuropathology of the Dysarthrias 369 Communicative Disorders Associated with Dysarthria 369

Types of Dysarthria 370 Assessment of the Dysarthrias 374

Treatment of the Dysarthrias 375

Dementia 377 Definition and Classification of Dementia 377 Dementia of the Alzheimer Type (DAT) 378

Frontotemporal Dementia (Including Pick's Disease) 379

Dementia Associated with Parkinson's Disease 380 Dementia Associated with Huntington's Disease 381 Infectious Dementia 382

Other Forms of Dementia 383 Assessment of Dementia 384

Clinical Management of Dementia 384

Right Hemisphere Syndrome 386 Foundational Concepts 386 Symptoms of Right Hemisphere Syndrome 387

Assessment of Right Hemisphere Syndrome 388

Treatment of Right Hemisphere Syndrome 389

Traumatic Brain Injury (TBI) 390 Definition and Incidence of TBI 390 Common Causes ofTBI 391

Types and Consequences of TBI 391 General Assessment of Patients with TBI 392

Assessment of Communicative Deficits Associated with TBI 393

Treatment of Patients with TBI 393

Swallowing Disorders 395 Nature and Etiology of Swallowing Disorders 396 Normal and Disordered Swallow 396

Assessment of Swallowing Disorders 398 Treatment of Swallowing Disorders 399





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CHAPTER 9

Communication Disorders in Multicultural Populations 415

Foundational Issues 416 Demographic Data 416

General Cultural Considerations 416

ASHA Guidelines Regarding Multicultural Issues 418

Speech-language Characteristics of ClD Clients 419 Dialects ofAmerican English 419

African American English 420

Characteristics ofAAE Morphology, Syntax, and Articulation 421

Spanish-Influenced English 422

English Influenced by Asian Languages 427

language Differences and language-learning Disabilities 429 Differentiating Language Differences From Language-Learning Disabilities 430

Acquiring a Second Language 431

Basic Interpersonal Communication Skills and Cognitive-Academic Language Proficiency 434

Assessment of ClD Clients 436 Legal Considerations 437

Considerations in the Use of Standardized Tests 437

Alternatives to Standardized Tests 440

Working with Interpreters in the Assessment Process 442

Treatment Considerations in Service Delivery to ClD Clients 443 Children with Language-Learning Disabilities 444 Prevalence and Incidence Rates of Medical Conditions and Communication Disorders 445

Potential Sociocultural and Linguistic Barriers to Service Delivery 446 Adults with Neurologically Based Disorders ofCommunication 446





CHAPTER 10

Audiology and Hearing Disorders 463

Anatomy and Physiology of Hearing 464 The Outer Ear 464 The Middle Ear 464

The Inner Ear 465

The Auditory Nervous System 466

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Acoustics: Sound and Its Perception 468 The Source of Sound 468

Sound Wav~s 469

Frequency and Intensity 470

Sound Pressure Level and Hearing Level 471

The Nature and Etiology of Hearing loss 472 Normal Hearing 472

Nature of Hearing Impairment 473

Conductive Hearing Loss 473

Sensorineural Hearing Loss 476

Mixed Hearing Loss 480

Auditory Nervous System Impairments 482

Assessment of Hearing Impairment 485 Audiometry: Basic Principles 485

Pure-Tone Audiometry 485

Speech Audiometry 486

Acoustic Immitance 486

Other Methods 487

Hearing Screening 488

Assessment of Infants and Children 488

Interpretation of Hearing Test Results 489

Management of Hearing Impairment 491 Communication Disorders of People with Hearing Impairment 491

Aural Rehabilitation: Basic Principles 495

Amplification 495

Communication Training 500





CHAPTER 11

Assessment and Treatment: Principles of Evidence-Based Practice 515

Evidence-Based Practice in Speech-language Pathology 515

Standard Assessment Procedures 516 Screening 517

Case History 517

Hearing Screening 520

Orofacial Examination 520

Interview 520

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Speech and Language Sample 521

Obtaining Related Assessment Data 523

Principles of Standardized Assessment 524 Nature and Advantages of Standardized Assessment 524

Limitations of Standardized Tests 525

Prudent Use of Standardized Tests 525

Types of Scores in Standardized Assessment 526

Validity and Reliability of Standardized Tests 527

Rating Scales, Questionnaires, and Developmental Inventories 530 Rating Scales 531

Questionnaires 531

Developmental Inventories 532

Alternative Assessment Approaches 532 Functional Assessment 532

Client-Specific Assessment 534

Criterion-Referenced Assessment 534

Authentic Assessment 535

Dynamic Assessment 535

Portfolio Assessment 535

Comprehensive and Integrated Assessment 535

Treatment of Communication Disorders: Basic Concepts 537 Treatment: Definition 537

A Treatment Paradigm for Communication Disorders 538

Basic Treatment Terms 539

Reinforcers and Reinforcement: Basic Definitions 542

An Overview of the Treatment Process 545 Selection of Treatment Targets 545

Treatment Sequence 547

Maintenance Program 548

Follow-Up 549

Booster Treatment 549

A General Outline of a Treatment Program 550 General Outline 550

Cultural-linguistic Considerations in Assessment and Treatment 551 The Need for Individualized Assessment and Treatment 551





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CHAPTER 12

Research Design and Statistics: A Foundation for Clinical Science 563

Essentials of the Scientific Method 563 The Philosophy of Science: Basic Precepts 564

Validity of Measurements 566

Reliability of Measurements 566

Experimental Research 568 Foundational Concepts 568

Group Designs of Research 569

Single-Subject Designs 571

Varieties of Descriptive Research 576 Foundational Concepts 576

Ethnographic Research 580

Evaluation of Research 581 Internal Validity 581

External Validity 584

Levels of Evidence for Evidence-Based Practice 585

Data Organization and Analysis: Principles of Statistics 587 Foundational Concepts 587

Statistical Techniques for Organizing Data 588

Types of Measurement Scales 590





CHAPTER 13

Special Topics in Speech-language Pathology 601

Counseling 601 Qualities Necessary for Effective Counseling 602

Approaches to Counseling 602

Special Issues in Counseling 606

Reactions and Emotions Related to Communication Disorders 606

Defense Mechanisms 607

Medical Speech-language Pathology 608 Practice and Responsibilities of Speech-Language Pathologists 609

Medical Team Specialists and Their Roles 610

Infectious Disease Control 612

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Working with HIV and AIDS Patients 613

Medical Imaging Techniques 614

Craniofacial Anomalies and Genetic Syndromes 615 Craniofacial Anomalies 616

Cleft Lip 616

Cleft Palate 616

Genetic Syndromes 624

Medically Fragile Infants 632 General Facts 632





CHAPTER 14

Professional Issues 647

ASHA and the Professions 647 The American Speech -Language-Hearing Association 648

The Professions of Speech-Language Pathology and Audiology 651

The Scope of Practice: Speech-Language Pathology 651

ASHA Accreditation 652

Issues in Certification and Licensure 653 Clinical Certification 653

Speech-Language Pathology Assistants 655

State Regulation of the Profession 656

Legislative Regulation of the Profession 656 Federal Legislation Affecting School Settings 657

Individuals with Disabilities Education Act (IDEA) 658

Federal Legislation Affecting Employment Settings 658

Federal Legislation Affecting Health-Care Settings 659

Future Trends 661





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APPENDIX 667

Nature and Purpose of the PRAXIS 667

Study Tips for Preparing for the PRAXIS 673

Tips for Taking the PRAXIS 674


Index 677

About the Authors 701

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Documents

Inc. PRO-ED, · Fundamentals of Resonation 15 Fundamentals ofArticulation 17 Neuroanatomy and Neurophysiology: ... language Development in Children 105 . Terms and Definitions 105