Dysphagia Oral and Pharyngeal

Dysphagia is an impaired ability to swallow. Dysphagia can result from anatomic variation or neuro-muscular impairment anywhere from the lips to the stomach. Although some investigators choose to consider the voluntary oral preparatory stage of deglutition as a separate stage, swallowing is traditionally described as a three-stage event (oral, pharyngeal, and esopha-geal). Historically, research as well as evaluation and treatment of dysphagia were directed primarily toward the esophageal...

References

Basso, A., Casati, G., and Vignolo, L. A. (1977). Phonemic identification defects in aphasia. Cortex, 13, 84-95. Baum, S. (1998). The role of fundamental frequency and duration in the perception of linguistic stress by individuals with brain damage. Journal of Speech and Hearing Research, 41, 31-40. Baum, S. R., Blumstein, S. E., Naeser, M. A., and Palumbo, C. L. (1990). Temporal dimensions of consonant and vowel production An acoustic and CT scan analysis of aphasic speech. Brain and Language,...

Language Ability and Stuttering in Young Children

The scholarly literature reveals a relatively longstanding view of the child who stutters as more likely to have language learning difficulties or impairments than typically developing peers. Through analysis of spontaneous language sample data, a group of scholars has empirically evaluated the expressive language abilities of a large cohort of young children who stutter (Watkins and Yairi, 1997 Watkins, Yairi, and Ambrose, 1999). The Illinois Stuttering Research Project has prospec-tively...

Poverty Effects on Language

More than one in five children in the United States live in poverty, with pervasive consequences for their health and development. These consequences include effects on language. Children who live in poverty develop language at a slower pace than more advantaged children, and, after the age at which all children can be said to have acquired language, they differ from children from higher income backgrounds in their language skills and manner of language use. Children from low-income families...

Bilingualism Speech Issues in

In evaluating the properties of bilingual speech, an anterior question that must be answered is who qualifies as bilingual. Scholars have struggled with this question for decades. Bilingualism defies delimitation and is open to a variety of descriptions and interpretations. For example, Bloomfield (1933) required native-like control of two languages, while Weinreich (1968) and Mackey (1970) considered as bilingual an individual who alternately used two languages. Beatens-Beardsmore (1982),...

Developmental Apraxia of Speech

Developmental apraxia of speech (DAS) is a developmental speech disorder frequently defined as difficulty in programming of sequential speech movements based on presumed underlying neurological differences. Theoretical constructs motivating understanding of DAS have been quite diverse. Motor-based or pre-motor planning speech output deficits (e.g., Hall, Jordon, and Robin, 1993), phonologically based deficits in representation (e.g., Velleman and Strand, 1993), or deficits in neural tissue with...

Pragmatics

Pragmatics may be defined as ''the study of the rules governing the use of language in social contexts'' (McTear and Conti-Ramsden, 1992, p. 19). Although there is some debate as to what should be included under the heading of pragmatics, traditionally it has been thought to incorporate behaviors such as communicative intent (speech acts), conversational management (turn taking, topic manipulation, etc.), presuppositional knowledge, and culturally determined rules for linguistic politeness....

Speech Disorders in Children Speech Language Approaches

Children with speech disorders often display difficulty in other domains of language, suggesting that they experience difficulty with the language learning process in general. A theoretical shift from viewing children's speech disorders as articulatory-based to viewing them from a linguistic perspective was precipitated by the application of phonological theories and principles to the field of speech pathology, beginning in the late 1970s. Implicit in this shift was the recognition that...

Vocalization Neural Mechanisms of

The capacity for speech and language separates humans from other animals and is the cornerstone of our intellectual and creative abilities. This capacity evolved from rudimentary forms of communication in the ancestors of humans. By studying these mechanisms in animals that represent stages of phylogenetic development, we can gain insight into the neural control of human speech that is necessary for understanding many disorders of human communication. Vocalization is an integral part of speech...

Speech Disfluency and Stuttering in Children

Childhood stuttering (also called developmental stuttering) is a communication disorder that is generally characterized by interruptions, or speech disfluencies, in the smooth forward flow of speech. Speech disfluencies can take many forms, and not all are considered to be atypical. Disfluencies such as interjections (um, er), phrase repetitions (''I want I want that), and revisions (I want I need that), which are relatively common in the speech of normally developing children, represent normal...

Further Readings

Memory impairments underlying language difficulties in dementia. Topics in Language Disorders, 18, 58-71. Azuma, T., Cruz, R., Bayles, K. A., Tomoeda, C. K., Wood, J. A., and Montgomery, E. B. (2000). Incidental learning and verbal memory in individuals with Parkinson's disease. Journal of Medical Speech-Language Pathology, 3, 163-174. Bayles, K. A. (1991). Age at onset of Alzheimer's disease. Archives of Neurology, 48, 155-159. Bayles, K. A. (1993)....

Reading Outcomes in Children with Language Impairments

The overlap between language impairments and reading disabilities has also been established by studies of the reading outcomes of children with language impairments. In the earliest of these studies, children with a clinical history of language impairments were located later in childhood or adulthood and their academic achievement was compared with their earlier speech-language abilities (Aram and Nation, 1980 Hall and Tomblin, 1978). More recently, studies have identified children with...

Auditory Brainstem Response in Adults

Normal Auditory Threshold

The auditory brainstem response (ABR) is a series of five to seven neurogenic potentials, or waves, that occur within the first 10 ms following acoustic stimulation (Sohmer and Feinmesser, 1967 Jewett, Romano, and Williston, 1970). The potentials are the scalp-recorded synchronous electrical activity from groups of neurons in response to a rapid-onset (< 1 ms) stimulus. An example of these potentials, with their most common labeling scheme using Roman numerals, is shown in Figure 1. Waves I...

Characteristics of American Sign Language and Other Natural Sign Languages

This entry focuses on American Sign Language (ASL) because it is the natural sign language used in the United States and it has been the most extensively studied. However, many of the issues raised here about the unique properties of natural sign languages and the normal pattern of acquisition of those languages by deaf children exposed to complete and early input apply to all natural sign languages. ASL and other natural sign languages are formally structured at different levels and follow the...

Clinical Decision Analysis

Clinical decision analysis (CDA) is a quantitative strategy for making clinical decisions. The techniques of CDA are largely derived from the theory of signal detection, which is concerned with extracting signals from noise. The theory of signal detection has been used to study the detection of auditory signals by the human observer. This article provides a brief overview of CDA. More comprehensive discussions of CDA and its application to audiological tests can be found in Turner, Robinette,...

Hearing Loss Screening The School Age Child

Among school-age children in the United States, it is estimated that nearly 15 have abnormal hearing in one or both ears (Niskar et al., 1998). With newborn hearing screening now available in nearly every state, many sensorineural hearing losses are identified prior to school entry. Even so, comprehensive hearing screening of school-age children is important, for several reasons. First, it will be years before universal infant hearing screening is fully implemented. Second, late-onset...

Early Semantic Development in Children with Developmental Language Disorders

Children with autism or other pervasive developmental disorders (PDDs) typically demonstrate semantic systems that are weak relative to the formal systems of syntax, morphology, and phonology. This weakness is manifested as use of words without regard to conventional meaning, context-bound extensions of word meaning, and confusion regarding the mapping of personal pronouns onto their referents. Social and cognitive deficits are thought to contribute to this weakness. Whereas normally developing...

Early Recurrent Otitis Media and Speech Development

Otitis media can be defined as inflammation of the middle ear mucosa, resulting from an infectious process (Scheidt and Kavanagh, 1986). When the inflammation results in the secretion of effusion, or liquid, into the middle ear cavity, the terms otitis media with effusion (OME) and middle ear effusion (MEE) are often used. Middle ear effusion may be present during the period of acute inflammation (when it is known as acute otitis media), and it may persist for some time after the acute...

Language Disorders in Adults Subcortical Involvement

The first suggestion of a link between subcortical structures and language was made by Broadbent (1872), who proposed that words were generated as motor acts in the basal ganglia. Despite this suggestion, according to the classical anatomo-functional models of language organization proposed by Wernicke (1874) and Lichtheim (1885), subcortical brain lesions could only produce language deficits if they disrupted the white matter fibers that connect the various cortical language centres....

Acquisition of ASL by Native Signing Children

Deaf children exposed at an early age to a sufficiently rich input acquire a full natural sign language as effortlessly and rapidly as hearing children acquire their native spoken language. Deaf babies ''babble'' in sign at about the same age as their hearing peers babble in speech, repeating the handshape or movement components of signs in a rhythmic fashion (Pettito and Marentette, 1991). Just as in canonical babbling the child's phonetic repertoire comes to be restricted to that of the...

Direct Voice Therapy

Voice therapy is one treatment modality for almost all types of neurological aging-related voice disorders. The recent explosion of knowledge about the larynx is matched by an equal growth of interest in its physiology, its disorders, and their treatment. Increased use of la-ryngeal imaging and knowledge of laryngeal physiology have provided a base for behavioral therapy that is increasingly focused on the specific nature of the observed pathophysiology. While treatment is designed to restore...

Conclusion

The visual-spatial nature of sign languages the fact that they are articulated with the hands and perceived through the eyes does not relegate them to the realm of pantomime and gesture. Natural sign languages are as subtle and complex as any spoken language and are structured according to universal linguistic principles. Deaf children exposed to a complete and consistent natural sign language early in childhood acquire the language normally, following the same stages and learning processes as...

Speech Disorders in Children Birth Related Risk Factors

The youngest clients who receive services from speech-language pathologists are neonates with medical needs. This area of care came into being during the last several decades as the survival rate of infants with medical needs improved and it became apparent that developmental delays would likely be prevalent among the survivors. Since 1970, for example, the survival rate of infants in some low birth weight categories jumped from 30 to 75 among the survivors the occurrence of mental retardation...

Classroom Acoustics

The acoustic environment of a classroom is a critical factor in the psychoeducational and psychosocial development of children with normal hearing and children with hearing impairment. Inappropriate levels of classroom reverberation, noise, or both can deleteriously affect speech perception, reading and spelling ability, classroom behavior, attention, concentration, and academic achievement. Poor classroom acoustics have also been shown to negatively affect teacher performance (Crandell,...

Language Disorders in Latino Children

The Latino population encompasses a diverse group of people who self-identify as descendants of individuals who came to the United States from a predominantly Spanish-speaking country. Over the past decade, the Latino population in the United States has increased four times faster than the general population (Guzman, 2001). It is estimated that the size of the Latino population will represent one-quarter of the U.S. population, or approximately 81 million Latinos, by the year 2050. The large...

Mental Retardation and Speech in Children

Mental retardation is defined by the American Association on Mental Retardation as significantly subaverage intellectual functions with related limitations in social and behavioral skills. According to the most recent estimates (Larson et al., 2001), the prevalence of mental retardation in the noninstitutionalized population of the United States is 7.8 people per thousand if institutionalized individuals are included in the prevalence rates, the number increases to 8.73 per thousand. Mental...

Dialect Versus Disorder

In 1983, the American Speech-Language-Hearing Association (ASHA) published a position statement on the topic of social dialects. A major point of the publication was to formally recognize the difference between language variation that is caused by normal linguistic processes (i.e., dialects) and variation that is caused by an atypical or disordered language system (i.e., language impairment). Through the position statement, ASHA also formally rebuked the practice of diagnosing and treating any...

Auditory Scene Analysis

Sensory systems such as hearing probably evolved in order for organisms to determine objects in their environment, allowing them to navigate, feed, mate, and communicate. Objects vibrate and as a result produce sound. An auditory system provides the neural architecture for the organism to process sound, and thereby to learn something about these objects or sound sources. In most situations, many sound sources are present at the same time, but the sound from these various sources arrives at the...

Otitis Media Effects on Childrens Language

Whether recurrent or persistent otitis media during the first few years of life increases a child's risk for later language and learning difficulties continues to be debated. Otitis media is the most frequent illness of early childhood, after the common cold. Otitis media with effusion (OME) denotes fluid in the middle ear accompanying the otitis media. OME generally causes mild to moderate fluctuating conductive hearing loss that persists until the fluid goes away. It has been proposed that a...

Speech Sampling Articulation Tests and Intelligibility in Children with Residual Errors

Children who have speech sound errors that have persisted past the preschool years are considered to have residual errors (Shriberg, 1994). Typically, these schoolage children have substitution and distortion errors rather than deletions, and intelligibility is not usually a primary issue. Children with residual errors generally have acquired the sound system of their language, but they have errors that draw attention to the speaking pattern. The assumption is usually made that they are having...

Specific Language Impairment in Children

Specific language impairment (SLI) is a term that is applied to children who show a significant deficit in their spoken language ability with no obvious accompanying problems such as hearing impairment, mental retardation, or neurological damage. This type of language disorder is regarded as developmental in nature because affected children exhibit language learning problems from the outset. Although SLI is receiving increased attention in the research and clinical literature, it is not a newly...

Audition in Children Development of

Research on auditory development intensified in the mid-1970s, expanding our understanding of auditory processes in infants and children. Recent comprehensive reviews of this literature include those by Aslin, Jusczyk, and Pisoni (1998), Werner and Marean (1996), and Werner and Rubel (1992). Two recurrent issues are whether the limitations of testing methods cause true abilities to be underestimated, and whether auditory development is substantially complete during infancy or continues into...

Speech and Language Disorders in Children Computer Based Approaches

Computers can be used effectively in the assessment of children's speech and language. Biofeedback instrumentation allows the clinician to obtain relatively objective measures of certain aspects of speech production. For example, measures of jitter and shimmer can be recorded, along with perceptual judgments about a client's pitch and intensity perturbations (Case, 1999). Acoustic analyses (Kent and Read, 1992) can be used to supplement the clinician's perceptions of phonological contrasts...

Language Impairment in Children Cross Linguistic Studies

For many years the study of language impairment in children focused almost exclusively on children learning English. The past decade has seen a decided and salutary broadening of this exclusive focus as researchers from many nations have become interested in understanding the impaired language acquisition of children speaking diverse languages. The concern for understanding the cross-linguistic nature of developmental language impairment has followed in the path of investigations into the...

Speech Issues in Children from Latino Backgrounds

Research into English phonological development in typically developing children and children with phonological disorders has been occurring since the 1930s (e.g., Wellman et al., 1931 Hawk, 1936). There is limited information on phonological development in Latino children, particularly those who are monolingual Spanish speakers and bilingual (Spanish and English) speakers. Over the past 15 years, however, phonological information collected on monolingual Spanish speakers and bilingual...

Social Development and Language Impairment

Social skills determine to a large extent the success we enjoy vocationally and avocationally and the amount of satisfaction we derive from our personal relationships. Social skill deficits in childhood have long been associated with a variety of negative outcomes, including criminality, underemployment, and psychopathology (cf. Gilbert and Connolly, 1991). The potential impact of developmental language impairments on social development is one of the most important issues facing families,...

Inclusion Models for Children with Developmental Disabilities

During 1998-99, 5,541,166 students with disabilities, or 8.75 of the school-age population ages 6-21 years, received special education and related services under Part B of the federal Individuals with Disabilities Education Act (IDEA) (U.S. Department of Education, 2000). IDEA specifies 13 disability categories based on etiological groupings. The largest single category of disability served is specific learning disabilities (50.8 ), with speech and language impairments the second largest...

Autism

The term autism was first used in 1943 by Leo Kanner to describe a syndrome of ''disturbances in affective contact,'' which he observed in 11 boys who lacked the dysmorphology often seen in mental retardation, but who were missing the social motivation toward communication and interaction that is typically present even in children with severe intellectual deficits. Despite their obvious impairments in social communication, the children Kanner observed did surprisingly well on some parts of IQ...

Anatomy of the Human Larynx

The larynx is an organ that sits in the hypopharynx, at the crossroads of the upper respiratory and upper digestive tracts. The larynx is intimately involved in respiration, deglution, and phonation. Although it is the primary sound generator of the peripheral speech mechanism, it must be viewed primarily as a respiratory organ. In this capacity it controls the flow of air into and out of the lower respiratory tract, prevents food from becoming lodged in the trachea or bronchi (which would...

Natural Sign Language Versus Artificial Signed Versions of Spoken Language

In several countries, signed versions of the native spoken language have been created by educators. Unlike natural sign languages, they are typically signed simultaneously with the spoken language as a form of sign-supported speech. In the United States there are several versions of manually coded English (MCE). The most widely used of these are Signed English, Signed Exact English, and Seeing Essential English. These all use lexical signs from ASL and English word order, but they vary in the...

Phonological Awareness Intervention for Children with Expressive Phonological Impairments

Phonological awareness refers to an individual's awareness of the sound structure of a language. Results from a number of studies indicate that phonological awareness skills are highly correlated with reading success (see Stanovich, 1980) and that phonological awareness can be enhanced by direct instruction (see Blachman et al., 1994). Some scientists prefer using the terms phonological sensitivity or metaphonology rather than phonological awareness. These three terms are generally considered...

Recommended Assessment Procedures

The following assessment guidelines are often referred to as the RIOT (review, interview, observe, test) protocol (Cheng, 1995, 2002). They are adapted here for Asian-Pacific American populations 1. Review all pertinent documents and background information. Many Asian countries do not have medical records or cumulative school records. Oral reports are sometimes unreliable. A cultural informant or an interpreter is generally needed to obtain this information because of the lack of English...

Functional Brain Imaging

Several techniques are now available to study the functional anatomy of speech and language processing by measuring neurophysiological activity noninvasively. This entry reviews the four dominant methods, electroencephalography (EEG) and magnetoencephalography (MEG), which measure the extracranial electromagnetic field, and positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), which measure local changes in blood flow associated with active neurons. Each of these...

Speech Perception Indices

The articulation index, or, as it is now known, the speech intelligibility index, was originally developed by early telephone engineer-scientists to describe and predict the quality of telephone circuits (Fletcher, 1921 Collard, 1930 French and Steinberg, 1947). Initially their motivation was to provide a method that would reduce the need for lengthy (and expensive) human articulation tests to evaluate the merit of telephone circuit modifications. However, by 1947, with the appearance of the...

Social Reintegration and Self Esteem

Self-esteem and self-worth are complex constructs, tied to social activity, that workers suggest should be central to psychosocial rehabilitation. The importance of self has been examined by Brumfitt (1993) using personal construct techniques. Facilitating participation in the community entails passing responsibility to the individual gradually so that the individual can develop autonomy, develop greater self-esteem, and take greater ownership of the issues that they face. The importance of...

The Cochlea

The cochlea performs a spectral analysis, sorting the incoming mechanical vibration into its different frequency components, and transduces the sound, turning the mechanical vibration into an electrical change that activates the fibers of the auditory nerve. The cochlea, deep inside the temporal bone, has a spiral central cavity, which curves the long (35-mm) cochlear duct into a small space 10 mm across. The canal is divided by membranous partitions into three spaces, or scalae, which run the...

Auditory Training

Auditory training includes a collection of activities, the goal of which is to change auditory function, auditory behaviors, or the ways in which individuals approach auditory tasks. Auditory training most commonly is associated with the rehabilitation of individuals with hearing loss, but it has been used with other populations that have presumed difficulties with auditory processing, such as children with specific language impairment, phonologic disorder, dyslexia, and autism (Wharry,...

Suprathreshold Speech Recognition

Suprathreshold refers to speech presented above the auditory threshold of the listener. Speech recognition is generally defined as the percentage of words or sentences that can be accurately heard by the listener. For example, a patient who could correctly repeat 40 out of 50 words presented would have 80 speech recognition. Because speech is a complex and continually varying signal requiring multiple auditory discrimination skills, it is not possible to accurately predict an individual's...

Aphasia Primary Progressive

The clinical syndrome of primary progressive aphasia is a diagnostic category applied to conditions in which individuals exhibit at least a 2-year history of progressive language deterioration not accompanied by other cognitive symptoms and not attributable to any vascular, neoplastic, metabolic, or infectious diseases. The disease is considered to be a focal cortical atrophy syndrome, as neuronal cell death is, at least initially, limited to circumscribed cortical regions and symptoms are...

Speechreading Training and Visual Tracking

Speechreading (lipreading, visual speech perception), a form of information processing, is defined by Boothroyd (1988) as a process of perceiving spoken language using vision as the sole source of sensory evidence'' (p. 77). Speechreading, a natural process in everyday communication, is especially helpful when communicating in noisy and reverberant conditions because facial motion in speech production may augment or replace degraded auditory information (Erber, 1969). Also, visual cues have...

Hearing Loss and the Masking Level Difference

The masking-level difference (MLD) (Hirsh, 1948) refers to a binaural paradigm in which masked signal detection is contrasted between conditions differing with respect to the availability of binaural differences cues. The most common MLD paradigm has two conditions. In the first, NoSo, both the masker and signal are presented in phase to the two ears. In this condition, the composite stimulus of signal plus noise contains no binaural difference cues. In the second condition, NoSp, the masker is...

Speech Development in Infants and Young Children with a Tracheostomy

A tracheostomy is a permanent opening of the trachea to outside air. It most often requires a surgical procedure for closure. The primary reason for performing a surgical tracheostomy is for long-term airway management in cases of chronic upper airway obstruction or central or obstructive sleep apnea, or to provide long-term mechanical ventilatory support. The use of assisted ventilation for more than 1 month in the first year of life has been considered to constitute a chronic tracheostomy...

Augmentative and Alternative Communication Approaches in Adults

An augmentative and alternative communication (AAC) system is an integrated group of components used by individuals with severe communication disorders to enhance their competent communication. Competent communication serves a variety of functions, of which we can isolate four (1) communication of wants and needs, (2) information transfer, (3) social closeness, and (4) social etiquette (Light, 1988). These four functions broadly encompass all communicative interactions. An appropriate AAC...

Pure Tone Threshold Assessment

Pure Tone Audiometry

Audiometry is the measurement of hearing. Clinical hearing tests are designed to evaluate two basic aspects of audition sensitivity and recognition (or discrimination). Hearing sensitivity measures are estimates of the lowest level at which a person can just detect the presence of a test signal (Ward, 1964). Measures that require an identification response or judgments of sound differences are tests of auditory acuity, recognition, or dis crimination. These tests provide information about a...

Intelligibility

Deficits in intelligibility vary according to the type of dysarthria as well as the relative contribution of the basic physiological mechanisms involved in speech respiration, phonation, resonance, and articulation. Medical (e.g., surgical, pharmacological), prosthetic (e.g., palatal lift), and behavioral interventions are used to improve the function of those physiological systems. Behavioral intervention for respiratory support focuses on achieving and maintaining a consistent sub-glottal air...

Auditory Neuropathy in Children

The disorder now known as auditory neuropathy (AN) has been defined only within the past 10 years (Starr et al., 1991), although references to patients with this disorder appeared as early as the 1970s and 1980s (Friedman, Schulman, and Weiss, 1975 Ishii and Toriyama, 1977 Worthington and Peters, 1980 Kraus et al., 1984 Jacobson, Means, and Dhib-Jalbut, 1986). This disorder is particularly deleterious when it occurs in childhood because it causes significant disturbance of encoding of temporal...

Speech Disorders in Children Motor Speech Disorders of Known Origin

By definition, children with a communication diagnosis of motor speech disorder have brain dysgenesis or have sustained pre-, peri-, or postnatal damage or disease to the central or peripheral nervous system or to muscle tissue that impairs control of speech production processes and subsequent actions of the muscle groups used to speak (respiratory, laryngeal, velopharyngeal, jaw, lip, and tongue) (Hodge and Wellman, 1999). This impairment may manifest with one or more of the following...

Hearing Aids Prescriptive Fitting

Prescriptive procedures are used in hearing aid fittings to select an appropriate amplification characteristic based on measurements of the auditory system. The advantages of using a prescriptive procedure as opposed to an evaluative or other approach are (1) they can be used with all populations in a time-efficient way, (2) they help the clinician select a suitable parameter combination from among an almost unlimited number possible in modern hearing aids and settings, and (3) they can be...

Functional Voice Disorders

The human voice is acutely responsive to changes in emotional state, and the larynx plays a prominent role as an instrument for the expression of intense emotions such as fear, anger, grief, and joy. Consequently, many regard the voice as a sensitive barometer of emotions and the larynx as the control valve that regulates the release of these emotions (Aronson, 1990). Furthermore, the voice is one of the most individual and characteristic expressions of a person a mirror of personality. Thus,...

Transsexualism and Sex Reassignment Speech Differences

According to the Random House Dictionary, a transsexual individual is ''A person having a strong desire to assume the physical characteristics and gender role of the opposite sex a person who has undergone hormone treatment and surgery to attain the physical characteristics of the opposite sex'' (Flexner, 1987). Brown and Rounsley (1996) explain, Transsexuals are individuals who strongly feel that they are, or ought to be, the opposite sex. The body they were born with does not match their own...

Aprosodia

Prosody consists of alterations in pitch, stress, and duration across words, phrases, and sentences. These same parameters are defined acoustically as fundamental frequency, intensity, and timing. It is the variation in these parameters that not only provides the melodic contour of speech, but also invests spoken language with linguistic and emotional meaning. Prosody is thus crucial to conveying and understanding communicative intent. The term aprosodia was first used by Monrad-Krohn (1947) to...

Parkinsons Dementia

Parkinson's disease is associated with a loss of striatal dopaminergic neurons, particularly in the pars compacta region of the substantia nigra. Tremor is the best recognized symptom and is present in approximately half of individuals with PD (Martin et al., 1983). Often tremor begins unilaterally, increasing with stress and disappearing in sleep. Other early symptoms include aching, paresthesias, and numbness and tingling on one side of the body that ultimately spread to the other side. Other...

Voice Disorders in Children

Investigations of voice using aerodynamic techniques have been reported for more than 30 years. Investigators realized early on that voice production is an aero-mechanical event and that vocal tract aerodynamics reflect the interactions between laryngeal anatomy and complex physiological events. Aerodynamic events do not always have a one-to-one correspondence with vocal tract physiology in a dynamic biological system, but careful control of stimuli and a good knowledge of laryngeal physiology...

Hypokinetic Laryngeal Movement Disorders

Hypokinetic laryngeal movement disorders are observed most often in individuals diagnosed with the neurological disorder, parkinsonism. Parkinsonism has the following features bradykinesia, postural instability, rigidity, resting tremor, and freezing (motor blocks) (Fahn, 1986). For the diagnosis to be made, at least two of these five features should be present, and one of the two features should be either tremor or rigidity. Parkin-sonism as a syndrome can be classified as idiopathic...

Speech Disorders in Children A Psycholinguistic Perspective

The terminology used to describe speech problems is rooted in classificatory systems derived from different academic disciplines. In order to understand the rationale behind the psycholinguistic approach, it is helpful to examine other approaches and compare how speech problems have been classified from different perspectives. Three perspectives that have been particularly influential are the medical, linguistic, and psycholinguistic perspectives. In a medical perspective, speech and language...

Voice Disorders of Aging

Voice disorders afflict up to 12 of the elderly population (Shindo and Hanson, 1990). Voice disorders in elderly persons can result from normal age-related changes in the voice production mechanism or from pathological conditions separate from normal aging (Linville, 2001). However, distinguishing between pathology and normal age-related changes can be difficult. Indeed, a number of investigators have concluded that the vast majority of elderly patients with voice disorders suffer from a...

Prosodic Deficits

Among the sequelae of certain types of brain damage are impairments in the production and perception of speech prosody. Prosody serves numerous functions in language, including signaling lexical differences when used phonemically in tone languages, providing cues to stress, sentence type or modality, and syntactic boundaries, and conveying a speaker's emotions. Any or all of these functions of prosody may be impaired subsequent to brain damage. The hemispheric lateralization of the brain lesion...

Dysarthrias Characteristics and Classification

The dysarthrias are a group of neurological disorders that reflect disturbances in the strength, speed, range, tone, steadiness, timing, or accuracy of movements necessary for prosodically normal, efficient and intelligible speech. They result from central or peripheral nervous system conditions that adversely affect respiratory, pho-natory, resonatory, or articulatory speech movements. They are often accompanied by nonspeech impairments (e.g., dysphagia, hemiplegia), but sometimes they are the...

Speech Tracking

Speech Tracking (sometimes called Connected or Continuous Discourse Tracking) is a procedure developed by De Filippo and Scott for training and evaluating the reception of ongoing speech'' (De Filippo and Scott, 1978, p. 1186). In the Speech Tracking procedure, a talker (usually a therapist or experimenter) reads from a prepared text, phrase by phrase, for a predetermined time period, usually five or ten minutes. The task of the receiver (the person with hearing loss) is to repeat exactly what...

Functional Hearing Loss in Children

Functional hearing loss (FHL) is frequently forgotten or misdiagnosed in the pediatric population, despite the fact that it is well documented (Bowdler and Rogers, 1989). The diagnosis is often missed in children because of lack of awareness of its manifestations (Pracy et al., 1996), its incidence (Barr, 1963), and its multiple causes (Broad, 1980). Functional hearing loss is one of several terms used to describe a hearing loss that cannot be ascribed to an organic cause (Aplin and Rowson,...

Augmentative and Alternative Communication Approaches in Children

The acquisition of communication skills is a dynamic, bidirectional process of interactions between speaker and listener. Children who are unable to meet their daily needs using their own speech require alternative systems to support their communication interaction efforts (Reichle, Beukelman, and Light, 2001). An augmentative and alternative communication (AAC) system is an Augmentative and Alternative Communication Approaches in Children integrated group of components used by a child to...

Orofacial Myofunctional Disorders in Children

Orofacial myology is the scientific and clinical knowledge related to the structure and function of the muscles of the mouth and face (orofacial muscles) (American Speech-Language-Hearing Association ASHA , 1993). Orofacial myofunctional disorders are characterized by abnormal fronting of the tongue during speech or swallowing, or when the tongue is at rest. ASHA defines an orofacial myofunctional disorder as ''any pattern involving oral and or orofacial musculature that interferes with normal...

Speech Disorders in Adults Psychogenic

The human communication system is vulnerable to changes in the individual's emotional or psychological state. Several studies show the human voice to be a sensitive indicator of different emotions (Aronson, 1991). Psychiatrists routinely evaluate vocal (intensity, pitch), prosodic (e.g., rhythm, rate, pauses), and other features of communication to diagnosis neurotic states (Brodnitz, 1981). Speech-language pathologists also consider the contributions of psychopathology in the evaluation and...

Laryngectomy

Total laryngectomy is a surgical procedure to remove the larynx. Located in the neck, where it is commonly referred to as the Adam's apple, the larynx contains the vocal folds for production of voice for speech. Additionally, the larynx serves as a valve during swallowing to prevent food and liquids from entering the airway and lungs. When a total laryngectomy is performed, the patient loses his or her voice and must breathe through an opening created in the neck called a tracheostoma. Total...

Speech Disorders in Children Behavioral Approaches to Remediation

Speech disorders in children include articulation and phonological disorders, stuttering, cluttering, developmental apraxia of speech, and a variety of disorders associated with organic conditions such as brain injury (including cerebral palsy), cleft palate, and genetic syndromes. Despite obvious linguistic influences on the analysis, classification, and theoretical understanding of speech disorders in children, most current treatment methods use behavioral techniques. The effectiveness of...

Speech Sound Disorders in Children Description and Classification

Children with speech sound disorders form a heterogeneous group whose problems differ in severity, scope, etiology, course of recovery, and social consequences. Beyond manifest problems with speech production and use, their problems can include reduced intelligibility, risk for broader communication disorders, and academic difficulties, as well as social stigma. Because of the heterogeneity of children's speech sound disorders, the description and classification of these disorders have been...

Linguistic Influences on Stuttering

There is ample evidence that stuttering events are influenced by linguistic variables. Brown (1945) was perhaps the first researcher to suggest linguistic influences on stuttering events with his groundbreaking report of apparent influences of a word's grammatical form class (i.e., content versus function word) on stuttering loci in adults who stuttered. In brief, Brown reported that adults who stuttered were significantly more likely to be disfluent on content words (e.g., nouns and verbs)...

Infectious Diseases

Viral laryngotracheitis is the most common infectious laryngeal disease. It is typically associated with upper respiratory infection, for example, by rhinoviruses and adenoviruses. Dysphonia is usually self-limiting but may create major problems for a professional voice user. The larger diameter upper airway in Infectious Diseases and Inflammatory Conditions of the Larynx 33 adults makes airway obstruction much less likely than in children. In a typical clinical...

Repertory Grids And Aphasia

Astrom, M., Adolfsson, R., and Asplund, K. (1993). Major depression in stroke patients A 3-year longitudinal study. Stroke, 24, 976-982. Brumfitt, S. (1985). The use of repertory grids with aphasic people. In N. Beail (Ed.), Repertory grid techniques and personal constructs. London Croom Helm. Brumfitt, S. (1993). Losing your sense of self What aphasia can do. Aphasiology, 7, 569-574. Code, C., H msl y, G., and Herrmann, M. (1999). The emotional impact of aphasia. Seminars in Speech and...

ABI24M Electrode Array

Close-up view of the 21-electrode array, which consists of 21 platinum disks mounted on a Silastic substrate. The fabric mesh backing is intended to encourage fibrous ingrowth to fix the electrode array in position. Figure 3. Close-up view of the 21-electrode array, which consists of 21 platinum disks mounted on a Silastic substrate. The fabric mesh backing is intended to encourage fibrous ingrowth to fix the electrode array in position. electrical current range. We estimate that ABI...

Phonological Errors Residual

Shriberg 1994 has conceptualized developmental phonological disorders as speech disorders that originate during the developmental period. In most cases the cause of such disorders cannot be attributed to significant involvement of a child's speech or hearing processes, cognitive-linguistic functions, or psychosocial processes Bernthal and Bankson, 1998 , but causal origins may be related to genetic or environmental differences Shriberg, 1994 Shriberg and Kwiatkowski, 1994 . Children with...