Primer On Communication And Communicative Disorders, A, 1st Edition Test Bank

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ContentsChapter1CommunicationandCommunicativeDisorders1Chapter2AnatomyandPhysiologyofSpeech,Language,andVoiceProduction$Chapter3SpeechSounds,Articulation,andPhonologicalDisorders13Chapter4LanguageDevelopmentinChildren24Chapter5LanguageDisordersinChildren34Chapter6CommunicationinaMulticulturalSociety445Chapter7NeurologicalImpairment:SpeechandLanguageDisordersinAdults522Chapter8VoiceDisorders6115Chapter9SwallowingDisorders69Chapter10FluencyDisorders79Chapter11AnatomyandPhysiologyofHearingandHearingDisorders88Chapter12HearingTestingandManagementofHearingDisorders96TestBank106AnswerKey192iii

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Chapter1COMMUNICATIONANDCOMMUNICATIVEDISORDERSContentOutline*COMMUNICATION©Definition:anexchangeofinformation(thoughts,feelings,orideas)betweenatleasttwoindividualsthroughsymbols,signs,orbehavior©Majorityofpopulationcommunicateprimarilythroughverbalexpression*Otherformsofcommunicationinvolvereading,writing,understandingfacialexpressions,usinggestures,andtouch2*Reading:Knowingwheretogoorwhattodoisunderstood~throughreadingi=*Writing:WetrytoimproveourwritingskillstoavoidaambiguitywhensharinginformationJL*Facialexpressions:Mostfacialexpressionsareinvoluntaryandtheyshowourinternalemotion.Sixuniversalexpressionsinclude:‘ooDisgust,sadness,happiness,fear,anger,andsurprise*Gestures:Manualcommunication,signlanguage,andfingerspellingaretheprimarygestures©AmericanSignLanguage(ASL):naturallanguageoftheDeafcommunityintheUnitedStatesanditdoesnotfollowtypicalEnglishgrammar*Definedas:aconceptuallanguagewithitsownstructureandrulesoItisimportanttounderstandthatsomegesturesusedintheUnitedStatesmightmeansomethingverydifferent(andevenoffensive)inadifferentcountry*Touch:Touchcanbeusedtocomfortorreassure,usedasahandshakewhengreeting,orusedtoshowloveoraffection©Alltheseformsshowthatcommunicationgoesfurtherthansimplytalkingtoanindividualtoconveyinformation*COMMUNICATIVEDISORDERSoWhenanindividualhasacommunicativedisorder,acommunicationbreakdownexistsbetweenthespeakerandlistenersoFourconceptsthatidentifythenatureofcommunicativebreakdownsinclude:1

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*Formulating:theabilitytoputthoughtsandideasintowords,signs,orsymbols*Transmitting:organizingandcoordinatingspeechmusclesorlimbs(signing)withthoughtsandideas*Receiving:abilitytouseoursensorysystemstotransmitinformationtothebrain*Comprehending:decodingandunderstandingthemessagethatwassentoEXAMPLESOFCOMMUNICATIVEDISORDERS’=Articulationdisorder:whenanindividualencountersaproblem=producingaspecificsound2*e.g,saying“wabbit”for“rabbit”JL*Dysarthria:weaknessofspeechmusclesduetobraindamage=Languagedisorder:anarrayofproblemswhichcouldaffectexpressiveand/orreceptivelanguage*e.g.unabletonamecommonobjects,unabletofollowmulti-steptasks,misuseofpronouns,andunabletomaintainaconversation*Stuttering(fluencydisorder):anindividualproducingsoundand/orsyllablerepetitionsorprolongationsthatdisrupttheflowofspeech*Voicedisorder:voicedisordersareperceptualeventsthatareidentifiedbyspeech-languagepathologistsorotolaryngologists.Theycanoccurfrommisusingandoverusingthevocalmechanism,neurologicaldisorders,andorganicdiseases*Professionssuchasteachingorsingingcanresultinvoicedisordersduetocontinuousabuseormisuseofthevoice*Hearingloss:dependingontheseverityofloss,individualsmayfinditdifficulttounderstandspeech.Individualsbornwithahearinglossmayhaveahardtimeacquiringspeech*PROFESSIONALSWHOWORKWiTHDISORDEREDCOMMUNICATION©Speech-LanguagePathologists(SLPs):trainedtoidentify,diagnose,treat,andhelptopreventcommunicativedisorders*Theprofessionworkswithindividualswhohavearticulation,language,fluency,voice,hearingproblems,andswallowingdisorders2

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*InordertobecomeanSLP,anindividualmustobtainamaster’sdegreefromagraduateprogramaccreditedbytheAmericanSpeech-Language-HearingAssociation(ASHA)*Afterobtaining36hoursofgraduateworkand400hoursofclientcontact,anSLPmustcompleteaclinicalfellowship:*36weeksofmentoredpractice*Aftertheclinicalfellowship,anSLPmustpassanationalexam*Onceeverythingiscomplete,thepersonisawardedtheCertificateofClinicalCompetenceinSLP(CCC-SLP):*Qualifiestheindividualtoprovideservicesinanyworksetting:educational,hospital,nursinghomes,long-term%carefacilities,privateclinics,not-for-profitclinics,home2healthcare,universityclinics,orconsultants2©Audiologists:trainedinthenonmedicaltreatmentofhearing,balance,andvotherrelatedproblemsi*Audiologistsworkwithindividualstodeterminetheirlevelofhearingandtorecommendamplificationdevices(e.g.,hearingaidsorcochlearimplants)*Theyalsoworkalongsideotolaryngologist(ENT—Ear,Nose,andThroatphysician)todeterminethebestamplificationdevice*Tobecomeatrainedaudiologist,majorityofgraduateprogramswillofferaclinicaldoctorateinaudiology(AuD).*Studentsmustcomplete75hoursofcourseworkand52workweeksundersupervisedclinicianpracticumexperiencewithina3—4yearperiod*StudentsmustalsopassthenationalexamtoreceivetheCertificateofClinicalCompetenceinAudiology(CCC-A)*Certificationandlicensureisrequiredinordertodispensehearingaidstopatients*Possibleplacesofemploymentinclude:*Hospitals,ENToffices,outpatientcarefacilities,universityclinics,hearingaidmanufacturers,andonrareoccasionsserveasexpertwitnessesinlegalcasesregardinghearinglossesintheworkplace,etc.*PROFESSIONALORGANIZATIONS©AmericanSpeech-Language-HearingAssociation(ASHA)*ProfessionalorganizationrepresentingandcredentialingSLPs,audiologists,andspeech-languageandhearingscientists3

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*Theorganizationhascreatedacodeofethicstomaintainthewelfareofclientsbeingtreated,maintainprofessionalcompetency,provideaccurateandhonestinformationtothepublic,andtomonitortheprofessionalstandardsofcolleaguesoAdditionalProfessionalOrganizations*Otherorganizationsexistthatspecializeindifferentareasofthespeechandhearingfieldsuchas:+InternationalFluencyAssociation*AmericanAcademyofAudiology*AcademyofDoctorsofAudiology*AcademyofNeurologicCommunicationDisorders%=CONCLUSION2oCommunicationgoesbeyondspeakingtoanotherindividual;itinvolves3writing,reading,facialexpression,gestures,andtouchv©Acommunicationdisordermaycauseacommunicationbreakdownwheniformulating,transmitting,receiving,orcomprehendingisimpairedo Speech-languagepathologistsandaudiologistsaretrainedprofessionalswhopracticeinthefieldofcommunicativedisordersandhearingloss,respectively©ASHAistheprofessionalorganizationforSLPsandaudiologists*RESOURCESoAcademyofNeurologicCommunicationDisordersandSciences* http//www.ancds.org©AmericanSpeech-Language-HearingAssociationwebsite* http://www.asha.orgoAmericanBoardofAudiology* http://www.americanboardofaudiologyorgoInternationalFluencyAssociation*http://www.theifa.org4

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Chapter2ANATOMYANDPHYSIOLOGYOFSPEECH,LANGUAGE,ANDVOICEPRODUCTIONContentOutline*CENTRALNERVOUSSYSTEMoDefinition:asystemforreceivingsensoryinformation,integratingthesesignalswiththoughtsandmemories,andorganizingthesethoughttocompleteanactionoComprisedofthe:*Brain:protectedbytheskull*SpinalCord:protectedbythespinalcolumn>©Meninges:threemembranouslayersthatprotectsthebrainandspinal3cord.Thethreelayersare:i=®Duramater:outermostlayer,toughandfibrousa*Arachnoidmater:secondlayer,web-likeAL*Piamater:innerlayer,delicatefibrousoBRAIN=Cerebrum:topmostportion®Thebrainisdividedintoleftandrightcerebralhemispheres*Corpuscallosum:allowsthetwohemispherestocommunicatewitheachotherthroughaconnectionoffibers*Longitudinalfissure:adeepindentationthatdividesthecerebralhemispheres*Rightandlefthemispheresarefurthereddividedupintofourlobes.Thelobesareidentifiedandseparatedthrough:* Gyri:hillsorridges* Sulci:indentations* Fissures:deeperindentations=TheFourLobes*FrontalLobe:primarymotorarea(motorcortex).Alsoplaysaroleinmotorplanning,emotionalcontrol,judgment,problemsolving,andsocializationoIfthemotorstripiselectricallystimulatedontheleftsideofthebrain,itcontrolstherightsideofthebodyoEfferentsignal:amotorsignalthatexitsthebraintomoveabodypart©Areasofthebodythatneedgreatermuscularcoordinationarerepresentedbylargerareasofthemotorstrip.Thisiscalledamotorhomunculus5

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=Forexample:themouthandtonguetakeupalargeareaonthemotorstripbecauseofthecomplexmotorcontrolneededforthesestructuresoBroca’sarea:speechmotorplanningarea*ParietalLobe:primarysensoryarea(sensorycortex)oIfpain,temperature,ortouchisfeltontheleftsideofthebody,therightsideoftheparietallobereceivestheinformationoAfferentsignal:sensorysignalsarrivingtothebrainoSimilartothefrontallobe,theareaswithgreater%sensoryreceptorsarerepresentedbylargerareasof2thesensorystrip2TemporalLobe:primaryauditorycortex.ArearesponsibleosforprocessingsoundiEoWernicke’sarea:thebrain’slanguagecenter*OccipitalLobe:primaryvisualcortexoReceivesandinterpretsvisualinformation*Structuresbelowthecerebrum:*Cerebellum:involvedwithmotorcoordination,balance,andmovement.AlsoplaysaroleindisorderssuchasstutteringandautismoLocatedbelowandtothebackofthecerebrum*Brainstem:vitalfunctionssuchasbreathingandheartratearecontrolledhere.Efferentandafferentsignalsrunthroughthebrainstem.Thebrainstemconsistsofthreestructures:oMidbrainoPonso Medulla:areawheremotorfiberscrosstosendinformationtotheoppositesideofthebodyo SpINALCORD*Thespinalcordextendsfromthebrainstemandpassesthroughanopeningintheskullandcontinuesdownthebonyspinalcolumn.Itisdividedintofivesegments:Cervical,thoracic,lumbar,sacral,coccygeal®PERIPHERALNERVOUSSYSTEMoDefinition:allneuraltissueoutsideofthebrainandthespinalcord.Themostimportantarespinalandcranialnerves6

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oSpinalnerves:31pairsofnervesthatoriginateinthespinalcord*Motorinformationistransmittedthroughthesenerves=SensoryinformationisreceivedandtransmittedtothebrainthroughthesenervesoCranialnerves*12nervesthatoriginateinthebrainstem*Twopurposes:¢Transmitsmell,vision,hearing,andtasteinformationfrombodilystructurestobrain*Transmitinformationfromthebraintoperformvoluntarymovementsoftheeyes,mouth,lips,tongue,andlarynx;0)*AUTONOMICNERVOUSSYSTEM2oMaintainsourinternalequilibriumvoTwobranches:15*Sympathetic:protectsandpreparesourbodiesforanysituationbyregulatingourheartrate,breathing,andsecretions*e.g,Ourheartracesandwemayperspiremorewhenfrightened* Parasympathetic:returnsourbodytoastateofequilibrium*ANATOMYANDPHYSIOLOGYOFSPEECHPRODUCTIONoORESPIRATORYSYSTEM*Twofunctions:*Breathing*Aidesintheproductionofspeech*Dividedintotwosections:*Upperrespiratorysystem:airwaysfoundwithinthenose,mouth,andthroatabovethevocalfolds*Lowerrespiratorysystem:beginsjustbelowthevocalfoldsinthetracheaandcontinuesintothelungs*AnatomyofBreathing*Thorax:airtightcavityformedbytheribcage,spinalcolumn,clavicle,andscapulathatlinkthelungswiththeribsthroughamembrane.Thisconnectionallowsthelungstomovewhentheribcagemoves*PulmonarySystem:includesthelungsandtheairwaysleadingtothelungs*Trachea:rigidbutflexibletube.Itisaseriesof20C-shapedcartilaginousrings7

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oBranchesinto>twobronchi,whichdividesinto->bronchioleswithinthelungsandthenturnsinto>alveolarducts,andfinallyendsin>alveolarsacs:tinyelasticsacswhereoxygenisexchangedforcarbondioxide*Diaphragm:dome-shapedmusclelocatedatthebottomofthethoraciccavity.Whencontracted,thediaphragmflattensoutandincreasesthesizeofthechestcavity.Thisinitiatestheprocessofbreathing=PhysiologyofBreathing*Boyle’sLaw>Energy=PressureXVolume;oThisstatesthatasvolumeincreases,thepressure2decreasesandviceversa3*StepsofbreathingvoContractandflattenthediaphragm(increasesivolumeanddecreasespressureofthoraciccavity)oAirflowsfromhighpressuretolowpressure,fillingupthelungswithair—inhalationoPressureinthelungsincrease,causingadecreaseinthethoraciccavitypressure©Airthenrushesoutbecausetheairpressureinthelungsisgreaterthanthepressureoutsideofthebody—exhalation*LungVolumeandCapacitiesoQuietrespiration:abreathingpatternthatoccurswhenapersonisquietlysittingoTidalVolume(TV):ameasurementoftheamountofairenteringandleavingthelungs©Forcedrespiration:abreathingpatternthatrequiresgreatervolumesofairoInspiratoryReserveVolume(IRV):takinglargerbreathstogetmoreairo ExpiratoryReserveVolume(ERV):exhalingtheIRVairoVitalCapacity(VC)=IRV+TV+ERVoResidualVolume(RV):airleftinlungsafterERVoTotalLungCapacity(TLC)=VC+RVoBreathingforairisadifferentprocessthanbreathingforspeech*Breathingforspeechinvolves:8

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oIncreasingthespeedofairtobuildenoughpressuretoblowthevocalfoldsapartoIncreasingthespeedofairbehindthestructuresinthemouthtocreatespeechsoundsoGreatervolumeofairisrequiredoShorteningtheinhalationprocesstoabout10%ofrespiratorytime,90%ofthetimeisspentexhalingoLARYNGEAL(PHONATORY)SYSTEM*Thelaryngealsysteminvolvesthelarynx(voicebox),whichhasimportantfunctionsforspeech:;*Actsasavalvetocontrolairflow,allowingthevocalfolds2toopenandcloseasairpassesthrough3*Producesvocalfoldvibrationtoproducesound.Thisisvknownasphonationi*AnatomyofSoundProduction*Cartilagesofthelarynx:oThyroidcartilage:largeststructureinthelarynxanditprotectsthevocalfoldsoCricoidcartilage:attachesunderneaththethyroidcartilageoArytenoidCartilages:apairofcartilagesthatsitontopofthecricoidcartilageandservesasanattachmentforthevocalfolds*Musclesofthelarynx:©Musclesattachtothecartilagestoabduct(open)oradduct(close)thevocalfoldsoVocalfolds:apairedmusclethatattachestothebacksideofthethyroidcartilage,crossesintheopeningofthecricoidscartilage,andattachestothearytenoidscartilageso Glottis:spacebetweenthevocalfolds*PhysiologyofSoundProduction*Myoelastic-AerodynamicTheoryofSoundProduction:anexplanationforourabilitytoproducesoundo Myo-:muscleso-elastic:stretchablepropertiesofthevocalfoldsoAerodynamic:movingair*Processofsoundproduction:oAnindividualclosesthevocalfolds9

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oPressurebuildsupbelowthevocalfolds:subglotticspace0SubglottalairpressureovercomestheresistanceofthevocalfoldsoVocalfoldsareblownapartandairrushesthroughtheglottisoVocalfoldscomebacktogetheroThisquickprocessisknownasonecycleofvocal-foldvibration.Inordertoproducesound,theprocessbeginsagainandagain.*Bernoulliprinciple:asthespeedoffluid(air)increases,the;pressuredecreases2oThisexplainswhythevocalfoldscomebackto3theirrestingpositionafterthesubglottalairisvreleasediEoTheelasticpropertiesofthevocalfoldsalsobringthefoldsbacktogether*Body-CoverModel:anotherproponentofvocal-foldvibrationoThismodelexplainsthatthevocalfoldsmovefrombottomtotopbecauseofthepressuredifferenceswithinthelarynxoVocalfoldsaremultilayered.Therefore,independentmovementofthetopandbottomoccur*Vocal-FoldVibration:oMales:occursonaverage125timespersecond©Females:occursonaverage225-250timespersecondoChildren:canoccurasfastas400timespersecond©Thesedifferencesoccurbecauseofthelengthandthicknessofthevocalfolds©Theindependentvibrationofthevocalfoldscreateabuzzingnoise©ARTICULATORYSYSTEM*AnatomyandPhysiologyofShapingSounds*Vocaltract:describedasalongtubethatstartsjustabovethevocalfoldsandendsatthelipsandnose.Responsibleforproducingspeechsounds.Madeupofthreecavitiesinwhichthesoundvibrates:10

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oPharyngealcavity:beginsatthevocalfoldsandendsbehindthemouthandnoseoOralcavity:beginsatthelipsandendsatthebackofthemouthoNasalcavity:beginsattheopeningofthenoseandendsinthebackatthepharyngealcavity*Voicelesssounds:soundsproducedbyopenedvocalfolds*Voicedsounds:soundsproducedbyclosedvocalfolds.AllEnglishvowelsarevoiced,includinghalfoftheconsonants*Articulation:movement*Articulators:structuresthatchangetheshapeandlengthof;thevocaltracttoproducespeechsounds.Theyinclude:2oTongue,hardpalate,softpalate(velum),mandible3(jaw).teeth,andlipsvoClosingandtighteningourlipshelpcreatepressure15tocreatecertainsounds.e.g.,/b/and/p/o Protrudingorextendingourlipscreatesalongervocaltracttocreatesoundslike“00”oSoftpalate(velum):separatesthenasalcavityfromtheoralcavityoTongue:Playsabigroleinproducingspeechsounds¢ Coarticulation:allowsustoproducesoundsinanefficientmannerbyanticipatingupcomingsoundsandmovingourarticulatorstoprepareforthosesounds®SUMMARYANDREVIEWoCentralnervoussystemismadeupofthebrainandspinalcord©Thebrainisseparatedintothefrontallobe(motorcortex),parietallobe(sensorycortex),temporallobe(auditorycortex),andoccipitallobe(visualcortex)oThespinalcordtransmitsinformationfromthecentralnervoussystemtotheperipheralnervoussystem.Theperipheralnervoussystemincludescranialandspinalnerves©RespirationplaysabigroleintheproductionofspeechoTherearevoiced(adductedvocalfolds)soundsandvoiceless(abductedvocalfolds)sounds.Speechsoundsareshapedthroughmovementofthearticulatorstochangethesizeandshapeofthevocaltract11

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®RESOURCESoBrainAnatomyandDiscussionofTraumaticBrainInjury* http://www.brainline.org/multimedia/interactive_brain/the_human_brain.html?gclid=COnV4Lex46ACFRMNDQod-jl71.woCross-SectionalAnatomy* hup://www.lumen.luc.edu/lumen/meded/grossanatomy/vhp/visible.htmoHowLungsWork=http://’www.lungusa.org/your-lungs/how-lungs-work/?gclid=CM2g47mw46ACFQOeDQodcDeBDwoViewsoftheLarynx;* http://www.entusa.com/larynx_videos.htm2oVocalTractVisualizationLabF*http://speech.umaryland.edu/index.htmlos12

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Chapter3SPEECHSOUNDS,ARTICULATION,ANDPHONOLOGICALDISORDERSContentOutline¢LANGUAGEANDSPEECHoDifferencebetweenspeechandlanguage*Language:systemofsymbolsusedforcommunicationandthoughtthatcanbespoken,written,orsigned=Speech:theabilitytorelatemeaningtohumanvoiceoPhoneme:amentalrepresentationofspecificspeechsounds=Ifwechangeaphonemewithinaword,itchangesthemeaning2=Phonemesarewrittenwithslashes-/p/,/b/,/t/,/k/=oPhone:anindividualproductionofthephonemei=o Allophone:variationsthatoccurfromproductiontoproductiona=Forexample,ifwechangeaphonemeinawordthenitchangesthewordJLmeaning,butifwechangethephonethemeaningremainsthesamebutsoundsdifferent®SOUNDSINENGLISHoInternationalPhoneticAlphabet(IPA):asetofsymbolstorepresenthumanspeechsounds=Englishusesabout40ofthephonemesrepresentedinIPA*Thissystemhelpstoavoidconfusionacrosslanguageswhenmultiplelettercombinationsareusedtorepresentthesounds*e.g,thesound“f”inEnglishisusedinavarietyofways—tough,photo,andflute.IfthesewordswerewritteninIPA,eachonewoulduse/1/.=IPAisusedtotranscribespeechasitisheardoClassificationofSpeechSounds=Vowels®AllvowelsarevoicedandtheyaremadewitharelativelyopenvocaltractoTheyareclassifiedaccordingtotongueheight(high,mid,low)andtongueposition(front,central,back)¢Diphthong:acombinationoftwovowelsbychangingtheshapeofthevocaltractwhenmovingfromonevoweltothenextoe.g,whenwesay‘buy’weusethevowel/a/andmovetothesecondvowel/1/=Consonants—consonantssoundshavethreeclassifications:®Place:wherethesoundisproducedinthevocaltractbythearticulators.Placeisidentifiedbytheeightplacesofproduction:oBilabial:soundsaremadewithtwolips,e.g.,/p/13

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oLabiodental:soundsaremadewiththelipsandteeth,e.g.,/f/oLinguadental(dental):soundsmadewiththetongueandteeth,e.g.,“th”oLingua-alveolar(alveolar):madewiththetonguepositionedatthealveolarridge,e.g.,/t/oLinguapalatal(palatal):soundsmadewiththetongueagainsttheroofofthemouth,e.g,“sh”oLinguavelar(velar):soundsmadewiththebackofthetongueandsoftpalate,e.g.,/g/oLabiovelar:soundsmadebythelipsandsoftpalate,e.g.,;wl2o Glottal:soundsmadeinthespacebetweenyourvocal3folds,e.g.,/IVre*Manner:typeofconstrictionandhowthebreathstreamisimanaged.Therearesevencategoriesofmanner:oStops(plosives):soundsmadebycompletelyblockingoffthevocaltract,buildingupairpressurebehindtheconstriction,andexplodingthesound,e.g.,/p/,/b/,/t/,/d/,/k/,and/g/oFricatives:soundsmadebyusingthetonguetocreateaconstrictionwithinthevocaltractandforcingthebreathstreamthroughtheconstriction,e.g.,/f/,/v/,/s/,and/z/oAffricate:soundsmadebycombingastopandafricative.Firsttheairisstoppedbehindaconstrictionandthenthesoundisreleasedthroughtheconstriction,e.g.,/tf/asin‘chew’and/d3/asin‘jewel’oGlide(semivowels):soundsmadebygraduallychangingtheshapeofthevocaltractasismovestotheadjacentvowel,e.g.,/w/oLiquids:=(lateral):soundsmadebytheairtravelingaroundtheconstrictionwithinthevocaltract,e.g.,/lI/14

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