Speech sound disorder by Sajjal (2018) Definition A speech sound - - PDF document

Speech sound disorder by Sajjal (2018) Definition

A speech sound disorder (SSD) is a speech disorder in which some speech sounds (called phonemes) in a child's (or, sometimes, an adult's) language are either not produced, not produced correctly, or are not used correctly.

Diagnostic Criteria

• A. Persistent difficulty with speech sound production that interferes with speech intelligibility or

prevents verbal communication of messages.

• B. The disturbance causes limitations in effective communication that interfere with social

participation, academic achievement, or occupational performance, individually or in any combination.

• C. Onset of symptoms is in the early developmental period.
• D. The difficulties are not attributable to congenital or acquired conditions, such as cerebral

palsy, cleft palate, deafness or hearing loss, traumatic brain injury, or other medical or neurological conditions.

Differential Diagnosis

Normal variations in speech. Regional, social, or cultural/ethnic variations of speech should be considered before making the diagnosis. Hearing or other sensory impairment. Hearing impairment or deafness may result in abnormalities of speech. Deficits of speech sound production may be associated with a hearing impairment, other sensory deficit, or a speech-motor deficit. Structural deficits. Speech impairment may be due to structural deficits (e.g., cleft palate). Dysarthria. Speech impairment may be attributable to a motor disorder, such as cerebral palsy. Neurological signs, as well as distinctive features of voice, differentiate dysarthria from speech sound disorder. Selective mutism.

Limited use of speech may be a sign of selective mutism . Selective mutism may develop in children with a speech disorder because of embarassment about their impairments, but many children with selective mutism exhibit normal speech in "safe" settings, such as at home or with close friends.

Screening/assessment

Informal assessment Case History The case history typically includes gathering information about Family's concerns about the child's speech; History of middle ear infections; History of speech, language, and/or literacy difficulties in the family; Languages used in the home; Primary language spoken by the child; Teacher's perception of the child's intelligibility and participation in the school setting and how the child's speech compares with that of peers in the classroom; Hearing screening to rule out hearing loss as a possible contributing factor to speech difficulties, Screening of oral motor functioning, Facial exam to identify structural bases for speech sound disorders (e.g., sub mucous cleft palate) and to assess facial symmetry. Differences among speech sound disorders, accents, dialects, patterns of transfer from one language to another, and typical developmental patterns. Observation Speech perception Receptive and expressive language assessment, Phonological processing Sounds in various word positions (e.g., initial, within word, and final word position) and in different phonetic contexts,

Phoneme sequences (e.g., vowel combinations, consonant clusters), Speech sound errors, including Error type(s) (e.g., deletions, omissions, additions), Error distribution (e.g., position of sound in word), Error patterns (i.e., phonological patterns)

Speech Sound Assessment/formal assessment Portage guide to early education

The guide comes in three parts A checklist of behavior,a card file,a manual of directions. Areas It comprised of five developmental areas plus a section on infant stimulation.area include self help,motor,socialization,language and cognitive skills. Age-birth to 6 years

Picture naming and imitation tests as tools for the diagnosis of phonological disorder

Within the phonology tests, three types of tasks are commonly used: imitation, naming and spontaneous speech. METHOD: participants of this research were 50 phonologically disordered children, with no history of prior speech-language therapy and with ages between 4:0 and 12 years. The spontaneous speech may be elicited direct or indirectly. In direct conditions, questions are used to evoke answers. The indirect speech collecting may be done through a free situation (selected materials and topics; the topics may or may not be related to the materials) or through history (use of some selected material and topics chosen by the child); In the imitation tasks, the subject is requested to repeat a word or sentence. In the naming task it is expected that the subject say the equivalent word to the picture or

• bject presented as stimulus. It's also usual to request the subject to produce the target word

in a standard sentence (Wertzner & Galea, 2002). if he/she does not recognize the

picture/object, the examiner may say the respective name and request the naming again after showing some items.(Wertzner & Galea, 2002). AIM: to verify the association between the phonological performance in picture naming and imitation tasks, assessing the occurrence of phonological processes.

Published tests of articulatoin

Goldman-Fristo Published in 2000 by Pearson Ronald Goldman and Macalyn Fristoe Purpose-the GFTA3 is used to assess an individuals articulation of consonant sound of standard American . English-it samples spontaneous and imitative speech production. Norms-2,350 examinees total Males:1798 Females:1723 Age-2;0 to 21;11 Potensial uses-the GFTA3 can compare articulation at different levels of complexity. It can formally observe the production of vowels and as well as note deviations. In addition the test can screen for expressive language difficulties. Section1:sounds in words. Section 2:sounds in sentences. Section 3:the ability of the examinee to produce previously misarticulated phonemes correctly when given mximum stimulation. Pros-the test has large colorful pictures and addresses all sounds in a concise manner.versatility among varying developmental ages. for example.in the second part of the test ,there is a choice

• f two stories that can be read to the individual .story 1 is directed towards younger patients

and story 2 can be enjoyed by older and younger clients. Reliability Evidence of inter rater reliability.

Evidence of test retest reliability. Evidence of internal consistency. Validity Evidence of content validity Evidence of construct validity

Arizona Articulation Proficiency scale

Developed by janet barker fudala Ages: 1-18 Grades: Infant-Adult Test all the major sounds in the English language including initial and final consonants and vowels, and diphthongs. Test Purpose The Arizona 3 provides a quick, reliable, and well-standardized measure of articulation proficiency in children. Additional Assessments Three Optional Assessment Tasks are available. Word Reading Administration Students read target words rather than naming objects on the Picture Cards. Language Screening Task On the back of almost every Picture Card is a follow-up question that can be used to elicit information about the students' vocabulary and language-based cognitive skills. Spontaneous Speech Task Two additional Picture Cards encourage spontaneous conversation. Testing Time-2-10 minutes Test Procedure

The student names objects represented on 42 picture cards. Score each response according to simple, quantitative rules detailed in the manual. Examiner Qualifications This test may be administered and interpreted by licensed and certified speech-language pathologists or educational professionals familiar with speech sound disorders. Components Test Set includes: examiner's manual, picture test cards, and 25 test booklets - distributed item

Diagnostic evaluation of articulation and phonology

Author -Dodd, Barbara J. Hua, Zhu Crosbie, Sharon Holm, Alison Ozanne, Anne Place of Publication London, England It contains following. How to administer the Screen: The child names all 10 pictures, clinician phonetically transcribes each word. Imitations allowed if semantic cue fails, but ensure an imitated word is also imitated in Any speech sound produced in error is tested for stimulability. Interpret Articulation Phonology

• romotor

Articulation Assessment: This dynamic assessment investigates children found not to be stimulable for one or more speech sounds they should pronounce by their age, on the Screening Assessment. Administration time: 5 -10 minutes. How to administer the Articulation Assessment: i. Picture naming: What’s this? Use cues as necessary to elicit the word, if unsuccessful ask for imitation, marking with (i). Circle any sounds produced in error. ii. Speech Sound Stimulability: Attempt to elicit any speech sound produced incorrectly when picture naming: ‘I am going to say a word and I want you to say it after me’ Give the child three opportunities, getting them to watch your lips, and providing cues. If the CV syllable is not elicited, attempt to elicit the speech sound in isolation, using cues, up to three times. As examples, these instructions work for some children: /f/ ‘Put your top teeth on your bottom lip, like this The Oromotor Assessment: Administration time: 5-10 minutes.

How to administer the Oromotor Assessment: See the score sheet for instructions. Most children tested during normative data collection were co-

• perative, but some refuse to make some oral gestures (e.g., tongue protrusion).

How to score the Oromotor Assessment: See the score sheet for instructions. Reliability studies showed that clinicians needed practice administering and scoring the Oromotor Assessment before they became reliable assessors. . The Phonological Assessment: The assessment is scored to provide the following quantitative measures with standard scores: Percent consonants correct (PCC) Percent vowels correct (PVC) Percent phonemes correct (PPC) Single-words vs continuous speech ratio (SvsC) The assessment also analyses error types qualitatively to identify type of phonological disorder Administration time: 15-20 minutes. How to administer the Phonological Assessment: Children are asked to name 50 pictures. If the wrong word is given, or a child doesn’t know a word, first provide a semantic cue, followed, if needed, by request for imitation. How to score the Phonological Assessment: 1. To work out quantitative severity measures: Percent Consonants Correct Count the number of consonants produced correctly. Divide this number by 141 (total possible) minus the number of consonants in any target words not attempted. Then multiply by 100. Administration time: 5-10 minutes. How to administer the Consistency Assessment: i. Ask the child to name the 25 pictures one at a time. ii. Do another activity (e.g., assessment such as oromotor test, game, read a story) iii. Again ask the child to name the same 25 pictures one at a time, indicate same production with ∝ or transcribe different production. iv. Do another activity v. Again ask the child to name the same 25 pictures one at a time, indicate same production with ∝ or transcribe different production. Many children protest that they have already named the pictures. Tell them they have to name the same pictures three times before the first trial and offer a reward for each trial. Use of a stopwatch, they can work, to measure time taken to say the words can encourage task completion. How to score the Consistency Assessment:

For each word that is said twice or three times, score 1 if any of the word is said differently, and 0 if the words are produced identically. Add the scores and express as a percentage of the number of words said on three occasions (e.g. 10 words said differently / 25 = 0.4 x 100 = 40%). 40% is the criterion for diagnosis of Inconsistent Phonological

Published Tests - Phonological Processes

Khan-lewis phonological analysis Khan-Lewis Phonological Awareness Second Edition (KLPA-2) Published in 2002 by Pearson Linda Khan and Nancy Lewis Assesses the phonological processes in the speech of individuals Latest edition Age Range - 2:0 - 21:11 Suitable for individual administration Takes 10-30 minutes to administer Purpose:

• Individually-administered test of phonological process usage, designed as a “companion tool”

to the Goldman-Fristoe Test of Articulation-Second Edition (GFTA-2), to provide further articulation and phonological diagnostic .. Standardization Issues:

• 3,500 examinees (ages 2-21) were initially tested at 300 sites nationwide, with final norms

based on representative sampling of 2,350 individuals (1,175 males, 1,175 females). Reliability and Validity Issues:

• Median internal, test-retest, and interrater reliabilities were all well-within acceptable limits

Hodson assessment of phonological pattern

Developed by-barbara Williams hodson Ages: 2 years to any age (if intelligibility is an issue); Normative data provided for Ages 3-0 to 8- Testing Time: 15-20 minutes (comprehensive); 2-5 minutes (screening)

Administration: Individual The third edition (formerly APP-R) is now norm-referenced. The HAPP-3 Comprehensive Phonological Evaluation can be administered in less than 20

• minutes. Objects and a few pictures are used to elicit 50 stimulus words.

identifying major phonological patterns that need to be targeted (for goal statement), and specifying consonant and vowel inventories, Two screening components are included--Multisyllabic words and Preschool. Two screening tools also are included (12 stimulus words for each). The child's productions are transcribed, analyzed, and summarized on either the Preschool Phonological Screening Record Form (for children 2 years of age and older) or the Multisyllabic Word Screening Record Form (for students 8 years of age and older). The screening instruments, which can be administered in less than 5 minutes, yield results that help the examiner determine whether further testing is needed.

Management plan

IEP of speech sound disorder 1.Bio data Name S.A Age 3 years 2.Strength-Understand words 3.Weekness-Production of sound Therapy –Oral motor exercise,blow technique IEP 1.strength the tongue,lips,and muscles of jaws. 2.movement of tongue or lips by placing honey. 3.blow the candle 4.whistling

1.weakn ess- producti

• n
• f

phonics 2.vowel words,a,e,I,o,u 3.consonants 4.syllable ma,ma 5.words Sessions 5 Target activity Teach phonics Rationale Production of phonics techniques Reinforcement Identification

• f

reinforcement Resources Cards,videos Trials 5

Oral motor therapy

Oral motor therapy works on the oral skills necessary for proper speech and feeding

• development. These skills include: awareness, strength, coordination, movement, and

endurance of the lips, cheeks, tongue, and jaw. . . FOR THE LIPS: Say "ooo" with exaggerated lip movement. Then say "eee." Combine them for "oo-ee." Really round the lips.

Sessions 5 Target activity Strength tongue,lips,muscles

• f

jaws(articulation) Rationale Improve speech articulation Techniques Oral motor exercise Reinforcement Identification

• f

reinforcement Resources Cards,videos Trials 5

Say "puh" and pop the sound with emphasis. Make a big smile. Relax and repeat. Puff out the cheeks while keeping the lips sealed. Relax and repeat. Puff out one cheek, then the other, then both. Then puff out the upper lip followed by the lower lip (or vice versa). Relax and repeat. Purse the lips to make a kiss. Slide the kiss to the right and then to the left or vice versa. Blow bubbles. You can also blow whistles, horns. Use these bubble straws to prevent kids from sucking up bubble solution when they blow. Drink through a straw rather than drinking from a cup. This is also a great activity for the tongue and cheeks. Drinking from a straw requires a lot of oral motor work: the cheeks tighten, the tongue tightens and retracts, and the lips purse. FOR THE TONGUE: Say "lalalalalalala" without moving the jaw up and down. Only move the tip of the tongue. Rest and repeat. If the jaw is moving doing this, have the child bite down on a Probe or Grabber to stabilize the jaw and isolate the tongue. Place the tongue tip on the alveolar ridge just behind the upper front teeth. Hold for as long as possible, working up to three minutes. Swallow when necessary, then get back into position.

• Practice tongue tip sounds. Say "t-t-t-t-t-t," "n-n-n-n-n-n," and "d-d-d-d-d-d." You can also

try a combination of these sounds, such at "t-d-n." Place the tongue tip on the alveolar ridge behind the upper front teeth. Then place it behind the bottom front teeth. Repeat several times. Place the tongue on the roof of the mouth. Hold it there with suction for about 5-10 seconds. Once that becomes easy, add another step: move the jaw up and down while keeping the tongue on the roof of the mouth. FOR THE CHEEKS: Use straws again! Put a prop reefer in the cheek area. Tighten the cheek around it. Relax and repeat. Put the lips together and contract the cheeks.

Make an "o" with the lips. Then move the lips in a circle. Repeat several times and then reverse the direction. FOR COORDINATION: Say "buttercup" 5 times in a row. Relax and repeat. You can also try saying "rocket ship" instead of "buttercup." Both words work the lips, the tip

• f the tongue, and the back of the tongue.

Put the tongue in the corner of the lips and trace the perimeter of the lips. When you reach the starting point, go back the other way. Focus on stabilizing the jaw and completing the circle. Don't allow the jaw to move at all - the tongue must do the work. Use a mirror. Look in the mirror and instruct the individual to copy you. Make it a fun game of "Simon Says." Mirrors are great for visual feedback as long as they aren't distracting. I have some kids who will just play and make funny faces in the mirror!

Blowing techniques

Water flutes . Its not often you find a resource that ticks lots of boxes – there’s a bit of science (the varying levels of water filled tubes dictates the pitch), music, bath fun and an activity that encourages steady blowing (to get a solid note). They even come with waterproof song/music sheets. Balloon ball budies. Balloon Ball Buddies are a fun way to help develop oral motor and respiration. They also provide a constructive alternative for kids who seek oral input. The Balloon Ball Buddy is just like a normal balloon, however it is larger and requires a bit more strength initially to inflate. There are 6 different styles of The Balloon Ball Buddy (The Hippo, Tiger, Frog, Fish, Elephant, Lion). The Balloon Ball Buddy is made from rubber, are more durable than a regular balloon. They can be used and re-used many times. Initially whistle Arks lip block The Ark Lip straw topper is a valuable tool to add to a straw to help children learn how to suck from a straw effectively. The Lip Block can help children develop oral motor skills such as lip closure, tongue retraction and cheek tension.

PLAY

• Alliteration. Repetition of early consonant sounds. ...

Consonance/Half-rhyme. Repetition of final consonant sounds. ...

• Assonance. Repetition of the same vowel sound. ...
• Rhyme. Repetition of the final vowel and the final consonant sounds. ...

Reverse Rhyme. ... Para Rhyme. ...

Phonic education technique

Children taught to read using phonics techniques have achieved "very high" results, according to new research, The results of the study, by the educational psychologist Marlynne Grant The new study followed a group of 30 children who were taught using phonics for the first time

Supporting Research

According to Laura Justice (KSHA presentation, 2005), the best predictors of successful development of decoding skills are alphabet knowledge, phonological awareness, and print- concept knowledge. Explicit teaching is necessary to ensure that students learn necessary skills for reading success. Only 24% of 4th grade students read proficiently and 37% do not have basic skills for reading.A 3 year longitudinal study of 12 preschool students with speech impairments and 19 preschool students with typically developing speech examined the effect of targeting phonological awareness skills during the preschool years (Gillon, 2005).The study revealed that early intervention which facilitates phoneme awareness and letter knowledge in addition to targeting improved speech intelligibility contributed to stronger phoneme awareness skills and eventually to improved decoding and encoding of printed words.

Augmentative and alternative communication(AAC)

Replacing natural speech and writing with aided(e:g picture communication symbols,line drawing,speech generating devices and tangible objects)and or unaided e: g ,manual signs,gestures and figure spelling)

Computer based instructions

Use of computer technology and computerized program for teaching language skills including vocabulary

Contextual Utilization

Contextual utilization approaches are based on the recognition that speech sounds are produced in syllable-based contexts in connected speech and that some contexts can facilitate correct production of a particular sound

Contrast Therapy

Contrast therapy focuses on production using contrasting word pairs instead of individual

• sounds. This approach emphasizes sound contrasts necessary to differentiate one word from

another

Cycles Approach

The cycles approach targets phonological pattern errors and is designed for highly unintelligible children who have extensive omissions, and a restricted use of consonants. The goal is to increase intelligibility within a short period of time, and treatment is scheduled in cycles ranging from 5 to 16 weeks. During each cycle, one or more phonological patterns are targeted. After each cycle has been completed, another cycle begins, targeting one or more different phonological patterns. Recycling of phonological patterns continues until the targeted patterns are present in the child's spontaneous speech (Hodson, 2010; Prezas & Hodson, 2010).

Distinctive Feature Therapy

Distinctive feature therapy focuses on elements of .This approach uses tasks (e.g., minimal pair contrasts) that compare the phonetic elements/features of the target sound with those of its substitution or some other sound contrast. (Blache & Parsons, 1980; Blache et al., 1981).

Naturalistic Speech Intelligibility Intervention

Naturalist speech intelligibility intervention directs treatment of the targeted sound in naturalistic activities that provide the child with frequent opportunities for the sound to occur. For example, using a McDonald's menu, the child can be asked questions about items that contain the targeted sound(s (Camarata, 2010).

Speech Sound Perception Training

Speech perception training is a procedure used to help the child acquire a stable perceptual representation for the target phoneme or phonological structure.

Ultrasound imaging (placing an ultrasound transducer under the chin) used as a biofeedback technique to visualize articulatory positioning and movement for vowel production (Adler-Bock, Bernhardt, Gick, & Bacsfalvi, 2007; Preston, Brick, & Landi, 2013);

REFERENCES

Adler-Bock, M., Bernhardt, B. M., Gick, B., & Bacsfalvi, P. (2007). The use of ultrasound in remediation of North American English /r/in 2 adolescents. American Journal of Speech- Language Pathology, 16(2), 128-139. Altshuler, M. W. (1961). A therapeutic oral device for lateral emission. Journal of Speech and Hearing Disorders, 26(2), 179-181. American Speech-Language-Hearing Association. (2007). Scope of practice in speech-language- pathology [Scope of Practice]. Available from www.asha.org/policy. Baker, E. (2012). Optimal intervention intensity. International Journal of Speech-Language Pathology, 14(5), 401-409. Bauman-Waengler, J. A. (2012). Articulatory and phonological impairments. New York, NY: Pearson Higher Education. Bernthal, J., Bankson, N. W., & Flipsen, P., Jr. (2013). Articulation and phonological disorders. New York, NY: Pearson Higher Education. http://www.readingrockets.org/article/speech-sounds-assessment-tip https://quizlet.com/158690712/assessment-of-speech-sounds-disorders-flash-cards/ American Speech-Language-Hearing Association. (2007). Scope of practice in speech-language- pathology [Scope of Practice]. Available from www.asha.org/policy. American Speech-Language-Hearing Association. (2010). Code of ethics [Ethics]. Available from www.asha.org/policy. Bauman-Waengler, J. A. (2012). Articulatory and phonological impairments. New York, NY: Pearson Higher Education. Bernthal, J., Bankson, N. W., & Flipsen, P., Jr. (2013). Articulation and phonological disorders. New York, NY: Pearson Higher Education. Bishop, D., & Adams, C. (1990). A prospective study of the relationship between specific language impairment, phonological disorders, and reading retardation. Journal of Child Psychology and Psychiatry, 31, 1027-1050.

Bleile, K. (2002). Evaluating articulation and phonological disorders when the clock is running. American CROSBIE, S.; HOLM, A.; DODD, B. Intervention for children with severe speecm disorder: a comparison of two aproaches. Int. J. Lang. Commun. Dis., v. 40, n. 4 , p. 467-491, oct.-dec. 2005. [ Links ] EDWARDS, M. L. Phonological assessment and treatment in support of phonological processes.

• Lang. Speech Hear. Serv. Sch., v. 23, n. 3, p. 233-240, jul. 1992. [ Links ]

https://coggle.it/diagram/V_a-VpBc7hEzI6-o/t/goldman-fristoe-test-of-articulation-3-gfta-3 http://www.linguisystems.com/products/product/display?itemid=10541 https://espace.library.uq.edu.au/view/UQ:177293 Dodd, B., McIntosh, B., Leahy, M. & Murphy, N. (2009). Atypical Speech in Irish Children: Identification and differential diagnosis. Journal of Clinical Speech & Language Studies, 17: 4-24. Dodd, B., Zhu H., Crosbie, S., Holm, A., & Ozanne, A. (2002) Diagnostic Evaluation of Articulation and Phonology. London: Psychological Corporation. http://www.ecasd.k12.wi.us/student_services/assessments/KLPA-2.pdf https://www.arktherapeutic.com/blog/easy-oral-motor-exercises-to-try-today/ https://starfisheducation.com.au/oral-motor-games-breathing-breathing-sucking-blowing/sssss Gillon, Gail T. (2005). Phonological Awareness: Evidence to Influence Assessment and Intervention Practices. Language, Speech, and Hearing Services in Schools, 36, 281-284. Justice, Laura. (2005). Evidence-Based Practice in Early Literacy Intervention. Kansas Speech Language Hearing Association Annual Conference Presentation.