Instructor’s Manual to accompany Introduction to Communication Disorders: A Lifespan Evidence-Based Perspective Fifth Edition Robert E Owens, Jr College of St Rose Kimberly E Farinella Northern Arizona University Dale Evan Metz Retired from SUNY Geneseo Prepared by Sarah A Dachtyl, Ph.D., CCC/SLP Sahuarita Unified School District Tucson Communication Therapies, LLC Boston Columbus Indianapolis New York San Francisco Upper Saddle River Amsterdam Cape Town Dubai London Madrid Milan Munich Paris Montreal Toronto Delhi Mexico City Sao Paulo Sydney Hong Kong Seoul Singapore Taipei Tokyo Copyright © 2015, 2011, 2007, 2003 by Pearson Education, Inc., Upper Saddle River, New Jersey 07458 All rights reserved Printed in the United States of America This publication is protected by Copyright and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise For information regarding permission(s), write to: Rights and Permissions Department Pearson® is a registered trademark of Pearson plc Instructors of classes using Owens/Metz/Farinella’s Introduction to Communication Disorders: A Lifespan Evidence-Based Perspective, 5e, may reproduce material from the instructor’s manual for classroom use 10 ISBN-10: 0133598306 ISBN-13: 9780133598308 www.pearsonhighered.com ii Table of Contents Instructor’s Manual: p 2-91 Test Bank with Answer Key: Chapter 1: p 93 Chapter 2: p 99 Chapter 3: p 110 Chapter 4: p 117 Chapter 5: p 132 Chapter 6: p 140 Chapter 7: p 154 Chapter 8: p 160 Chapter 9: p 169 Chapter 10: p 176 Chapter 11: p 184 Chapter 12: p 194 Chapter 13: p 206 CHAPTER THE FIELD, THE PROFESSIONALS, AND THE CLIENTS Chapter Learning Goals Describe communication impairment Describe the roles of audiologists, speech/language pathologists, and speech, language, and hearing scientists Outline the history of changing attitudes toward individuals with disabilities over the centuries and especially legislation over the past several decades Describe how evidence-based practice (EBP) influences clinical decisions Introduction Communication is part of what makes us human We will explore the nature of communication disorders in this text In the first chapter, we introduce the professionals who work with individuals who have communication disorders In addition, the roles of other team members will be discussed, as well as evidence-based practice and a historical perspective of laws that mandate appropriate care Content Outline HELPING OTHERS TO HELP THEMSELVES Reasons for becoming a SLP or audiologist vary from person to person Some may want to contribute to the general good of society, and others may have experience with individuals with communication disorders in their family or circle of friends COMMUNICATION DISORDERS A communication disorder may affect any and all aspects of communication; it may affect hearing, language, and/or speech Speech disorder: Atypical production of speech sounds, interruption in the flow of speaking, or abnormal production and/or absence of voice quality (pitch, loudness, resonance, and/or duration) Language disorder: Impairment in comprehension and/or use of spoken, written, and/or other symbol systems Hearing disorder: A result of impaired sensitivity of the auditory or hearing system Central auditory processing disorders: Deficits in the processing of information from audible signals Communication disorders are NOT differences, such as dialectal differences or multilingualism Augmentative/alternative communication systems: Attempts often taught by SLPs to compensate and facilitate for impaired communication using, for example, signing or digital methods THE PROFESSIONALS Audiologists: Measure hearing and identify, assess, manage, and prevent disorders of hearing (including auditory processing disorders) and balance They may dispense hearing aids Credentials for Audiologists Educational requirements are 3-5 years of professional education beyond the bachelor’s degree This culminates in a doctoral degree, either an AuD, PhD, or EdD in audiology ASHA CCC-A: Requires doctorate, professional experience, national exam State license is often needed and is frequently identical to ASHA CCC Speech-Language Pathologists: Identify, assess, treat, and prevent expressive and receptive communication disorders in all modalities They provide services for swallowing disorders and may be involved in modifying dialects Credentials for SLPs Public schools require at least a bachelor’s degree, but most states require a master's degree Requirements vary from state to state ASHA CCC-SLP: Requires master's degree or doctorate, professional experience, professional development, national exam State license often needed and is frequently identical to ASHA CCC There may also be additional requirements for the state’s department of education school certification Speech, Language, and Hearing Scientists: Extend knowledge of human communication processes and disorders They usually have doctorate degrees and are employed by universities, government agencies, industry, and research centers Some may also work clinically ♦ What Speech, Language, and Hearing Scientists Do Speech scientists may be involved in basic research exploring anatomy, physiology, and physics of speech-sound production Investigate the causes, prevention, and treatment of various speech impairments Development of computer-generated speech Language scientists may investigate the ways children learn language Conduct cross-cultural studies of language and communication Study how languages are changing Examine language disabilities and the nature of language disorders in children and adults Hearing scientists investigate the nature of sound, noise, and hearing They may help develop equipment for hearing assessment Develop techniques for testing infants or those with physical or psychological impairments Develop and improve assistive listening devices Concerned with conservation of hearing and limiting environmental noise Professional Aides: Work with supervision to assist audiologists and SLPs Their titles, educational requirements, and responsibilities vary amongst states that permit their employment They may work only with supervision and there are limits to the tasks in which they can be involved Related Professionals: A Team Approach: Teams can include family members, regular and special education teachers, psychologists, social workers, physicians and other medical personnel, and occupational, physical, and music therapists They may collaborate with physicists and engineers SERVICE THROUGH THE LIFESPAN Individuals with communication disorders may be of any age in people has a disability, and the likelihood increases as we age Infants are screened for hearing loss and other disabilities as soon as they are born Babies and toddlers may exhibit developmental delay An interdisciplinary approach is necessary in the assessment and treatment of young children, and an IFSP is developed for each child, which is directed to the entire family Early intervention is highly valuable and may prevent later difficulties Preschoolers may attend a special school where professionals can address the child’s needs Almost half of all SLPs are employed in school systems School-age children with communication difficulties often experience academic and social difficulties 1.5 to million Americans sustain a traumatic brain injury each year and may have subsequent communication or swallowing impairments In those over age 65, stroke, neurological disorders, and dementia may interfere with communication and swallowing Hearing loss may affect at least one quarter of older adults Evidence-Based Practice ♦ SLPs and audiologists must provide the most effective intervention based on available evidence ♦ Clinical decision-making: combination of scientific evidence, clinical experience, and client needs ♦ ♦ ♦ ♦ ♦ ♦ ♦ Assumptions of EBP: Clinical skill grows from experience and current available data The SLP or audiologist seeks new therapeutic information to improve efficacy Professional, peer-reviewed journals are the best source of clinical evidence ASHA has established the National Center for Evidence-Based Practice in Communication Disorders, but comprehensive assessment and intervention guidelines are still works in progress Efficacy: The probability of benefit from an intervention under ideal conditions There are three key elements: It refers to an identified population, not specific individuals The treatment should be focused and the population should be clearly identified The research should be conducted under optimal intervention conditions, although actual clinical conditions may be less than ideal Effectiveness: The probability of benefit from an intervention method under average conditions It is what works in real-world application of intervention Efficiency: The quickest and least effortful method resulting in the greatest positive benefit Additional factors affecting clinical decision making include the clinician’s expertise, experience, attitude, and motivation, client/family values and characteristics, and service delivery variables Providing the best intervention possible is of foremost concern Intervention options and supporting evidence should be discussed with clients and/or family members COMMUNICATION DISORDERS IN HISTORICAL PERSPECTIVE Disorders are not new but attitudes toward them have changed throughout the centuries By the late 1700s, special residences were designed for individuals with specific disorders The first U.S “speech correctionists” were educators and others who took an interest in speech problems The first professional journal related to communication, The Voice, was established in 1879 Early interest groups included teachers within the National Education Association and the National Association of Teachers of Speech The American Academy of Speech Correction was formed in 1925, a precursor to ASHA Audiology became a profession in the 1920s and experienced a boom in the 1940s due to World War II veterans who were experiencing noise-induced hearing loss The American Coalition of Citizens with Disabilities was created in 1974 Select federal mandates affecting people with communication disabilities: 1975: Education for All Handicapped Children Act (EAHCA) (Public Law 94-142) Mandated that a free and appropriate public education (FAPE) must be provided for all handicapped children between ages and 21 1986: Education of the Handicapped Amendments (Public Law 99-457) Extended age of those served to cover children between the ages of birth and years 1990: Individuals with Disabilities Education Act (IDEA) Addressed the multicultural nature of the U.S 2004: Reauthorization of IDEA Established birth-to-6 programs as well as new early intervention services Summary SLPs, audiologists, and other specialists work to assist individuals with communication impairments They work in a variety of settings and with people throughout the lifespan Clinicians have a minimum of a master’s degree and supervised clinical experience, and generally have the ASHA CCCs ASHA is the largest organization of professionals working with communication disorders ASHA’s missions include the scientific study of human communication, provision of clinical service in speech/language pathology and audiology, maintenance of ethical standards, and advocacy for individuals with communication disabilities Federal legislation currently mandates services for people with disabilities Suggested Resources Print Resources Nicolosi, L., Harryman, E., & Kresheck, J (2003) Terminology of communication disorders: Speech, language, and hearing (5th ed.) Baltimore: Williams & Wilkins Peterson’s Guides (Ed.) (2013) Graduate & Professional Programs: An overview 2013 Princeton, NJ: Peterson’s (published annually) Singh, S (Ed.) (2000) Singular’s illustrated dictionary of speech-language pathology San Diego: Singular Audiovisual and Online National Institute on Deafness and Other Communication Disorders (NIDCD): www.nidcd.nih.gov American Academy of Audiology (AAA): http://www.audiology.org American Speech-Language-Hearing Association (ASHA): http://asha.org Acoustical Society of America (ASA): http://asa.aip.org Peterson's Guide to Graduate and Professional Study: http://www.petersons.com/ Suggested Activities Ask students why they are taking this course Arrange for students to shadow a speech-language pathologist or audiologist for a day After writing a journal of their observations, students can compare notes in class Have students interview a person with a communication disorder or have an individual visit the class How was this person's life affected by the disorder? What kind of help has the person received? Students can prepare additional questions Project the ASHA website to demonstrate the available resources for students Invite fellow faculty members to class to briefly describe their research projects to show students what speech, language, and hearing scientists in their department are involved in CHAPTER TYPICAL AND DISORDERED COMMUNICATION Chapter Learning Goals Explain the role of culture and environment in communication Describe what is involved in human communication Demonstrate how communication disorders may be classified Name some types of communication disorders Discuss and estimate the frequency of occurrence of communication disorders Describe in general the assessment and intervention process Content Outline HUMAN COMMUNICATION The Social Animal Communication: An exchange of ideas between sender(s) and receiver(s) Sociolinguistics: How cultural identity, setting, and participants influence communication Cultural Identity Refers to our language and cultural communities (nationality, age, gender, ethnicity, etc.) Means of Communication ♦ Language: A socially shared tool that is used to represent concepts It uses arbitrary symbols that are combined in rule-governed ways Grammar refers to the rules of a language Linguistic intuition is the recognition of "right" or "wrong" grammar by native speakers Generative means that each utterance is freshly created Dynamic means that languages change over time All languages have three primary components: Form, Content, and Use Form consists of phonology, morphology, and syntax Phonology is the sound system of a language Phonotactic rules specify how sounds may be arranged in words Morphology involves the structure of words Morphemes are the smallest grammatical units in a language Free morphemes may stand alone as a word Bound morphemes change the meaning of the original words and can only be attached to free morphemes Syntax is how words are arranged in a sentence and the ways in which one word may affect another Content consists of semantics Semantics refers to the content or meaning of language Semantic features are pieces of meaning that define a particular word Use consists of pragmatics, which is how and why we use language Pragmatic rules vary with culture ♦ Speech: The process of producing the acoustic representation of language Articulation is the way speech sounds are formed Fluency is the smooth, forward flow of communication, influenced by rhythm and rate Rate is the speed at which we talk Rate and rhythm are components of prosody, or speech suprasegmentals ♦ Voice can reveal things about the speaker and the message Both the overall level of loudness and the loudness pattern within sentences and words are important Pitch is a listener’s perception of how high or low a sound is (frequency) Habitual pitch is the basic tone that an individual uses most of the time Intonation is the pitch movement within an utterance ♦ Nonverbal Communication: About 2/3 of human meaning exchange is nonverbal Nonverbal encompasses both the suprasegmental aspects of speech and the nonvocal and nonlinguistic aspect of communication Artifacts: How you look, your clothes, your possessions, music you listen to, etc Kinesics: The way we move our body, or body language Explicit movements are clearly defined Implicit movements are more general or subtle Space and Time Proxemics is the physical distance between people as it affects communication Tactiles are touching behaviors Chronemics is the effect of time on communication COMMUNICATION THROUGH THE LIFESPAN Infants must first learn the rudiments of communication and begin to master speech The early establishment of communication between children and caregivers fosters the development of speech and language, which influence the quality of communication This is complicated by physical, cognitive, and social development The key to becoming a communicator is being treated as one The process of learning speech and language is a social one that occurs through interactions of children and the people in their environment Every person’s speech and language continues to change until the end of life A competent communicator continues to adapt to changes in the language and in the communication process COMMUNICATION IMPAIRMENTS Communication disorders consist of disorders of speech (articulation, voice, resonance, fluency), oral neuromotor patterns of control and movement, language impairment, feeding and swallowing disorders, cognitive and social communication deficits, and hearing and processing difficulties May be categorized on the basis of whether reception, processing, and/or expression are affected Etiology is the cause/origin of a problem, and may be used to classify a communication problem ♦ Faulty learning, neurological impairments, anatomical or physiological abnormalities, cognitive deficits, hearing impairment, or damage to any part of the speech system Congenital: Present at birth Acquired: The result of illness, accident, or environmental circumstances later in life Severity is also used to characterize communication disorders, ranging from mild to profound Variations in communication are not impairments Dialects: Differences that reflect a particular regional, social, cultural, or ethnic identity A holistic approach to the diagnosis and treatment of people with communication impairments is used in this text Language Disorders Disorders of Form Errors in sound use constitute a disorder of phonology Incorrect use of past tense or plural markers is an example of a disorder of morphology Syntactical errors include incorrect word order and run-on sentences May be due to sensory limitations, perceptual difficulties, limited exposure to correct models, etc Disorders of Content Limited vocabulary, misuse of words, or word-finding problems Difficulty understanding and using abstract language May be due to limited experience, concrete learning style, strokes, head trauma, or certain illnesses Disorders of Use Pragmatic impairments may stem from limited or unacceptable conversational, social, and narrative skills; deficits in spoken vocabulary; and/or immature or disordered phonology, morphology, and syntax Might include difficulty staying on topic, providing inappropriate or incongruent responses to questions, or continually interrupting the conversational partner Speech Disorders: May involve articulation, fluency, or voice Disorders of Articulation Articulation: The actual production of speech sounds It is not always easy to determine whether an individual’s speech-sound errors indicate an impairment of phonology (a language problem) or articulation The causes of articulation disorders include neuromotor problems such as cerebral palsy, physical anomalies such as cleft palate, and faulty learning Dysarthria is a speech disorder caused by paralysis, weakness, or poor coordination of the speech musculature Apraxia of speech is a speech disorder that is due to neuromotor programming difficulties Disorders of Fluency The smooth, uninterrupted flow of speech is affected Developmental disfluency: Speech patterns common to young children (~age 3) Fillers: Examples include “er,” “um,” and “ya know.” Hesitations: Unexpected pauses Repetitions: Sounds or words are repeated, as in “g-go-go.” Prolongations: Excessively long duration, as in “wwwwwwwell.” Stuttering: When these speech behaviors exceed or are qualitatively different from the norm or are accompanied by excessive tension, struggle, and fear Fluency disorders are generally first noticed before age Adult onset of stuttering can also occur The causes of nonfluent speech are typically unclear Voice Disorders Congenital physiological conditions can affect voice, but are relatively rare Vocal abuse: Excessive yelling, screaming, or loud singing Can result in hoarseness or another voice disorder Habits such as physical tension, coughing, throat clearing, smoking, and drinking alcohol can disrupt normal voice production Can result in pathology such as polyps, nodules, or ulcers Other causes: Disease, trauma, allergies, and neuromuscular or endocrine disorders Hearing Disorders Deafness When a person’s ability to perceive sound is limited to such an extent that the auditory channel is not the primary sensory input for communication It may be congenital or acquired Interventions Total communication is considered the most effective Assistive listening devices, cochlear implants, and auditory training are helpful Hard of Hearing People who are hard of hearing depend primarily on audition for communication Hearing loss may be temporary or permanent Hearing loss is categorized in terms of severity, laterality, and type Severity may range from mild to severe The loss can be bilateral (involving both hears) or unilateral (involving one ear) The type of loss can be conductive, sensorineural, or mixed Conductive: Caused by damage to the outer or middle ear Sensorineural: Problems with the inner ear and/or auditory nerve Mixed: Both conductive and sensorineural losses Auditory Processing Disorders 10 17 Amost half of all SLPs are employed a In school systems b In healthcare c In private practice d All of the above combined 18 In addition to the entry-level degree, what else audiologists need in terms of credentials? 19 School-age children with communication difficulties often experience a Academic difficulties b Social difficulties c Neither of the above d A&B 20 In addition to the entry-level degree, what else to SLPs need in terms of credentials? 21 How many Americans sustain a traumatic brain injury each year? a 500,000-750,000 b 1.5-2 million c 2-4 million d None of the above 22 What are the assumptions of evidence-based practice? 23 Hearing loss may affect at least a 25% of older adults b 50% of older adults c 75% of older adults d Nearly all older adults 24 What is involved in clinical decision-making? 25 The best source(s) of clinical evidence is/are a Company websites b Magazine articles c Professional, peer-reviewed journals d All of the above 26 What are the three key elements of efficacy? 27 Efficacy is a The quickest and least effortful method resulting in the greatest positive benefit b The probability of benefit from an intervention under ideal conditions c Both of the above d Neither of the above 16 28 What are some factors that affect clinical decision making? 29 Effectiveness is a The quickest and least effortful method resulting in the greatest positive benefit b The probability of benefit from an intervention under ideal conditions c Both of the above d Neither of the above 30 Name and briefly describe four federal mandates affecting people with disabilities 31 The first professional journal related to communication was called a The Voice b Speech Correction c Journal of the National Association of Teachers of Speech d None of the above 32 _ was the precursor to ASHA a The National Education Association b The American Academy of Speech Correction c American Coalition of Citizens with Disabilities d The Education for All Handicapped Children Agency 33 Audiology became a profession in a The 1890s b The 1920s c The 1940s d The 1950s 34 Audiology experienced a boom in which decade due to WWII veterans who were experiencing noise-induced hearing loss? a The 1910s b The 1920s c The 1940s d The 1950s 17 CHAPTER – Answer key THE FIELD, THE PROFESSIONALS, AND THE CLIENTS D A B C D B C B B 10 C 11 C 12 A 13 D 14 A 15 A 16 Acceptable responses: Speech scientists may be involved in basic research exploring anatomy, physiology, and physics of speechsound production Investigate the causes, prevention, and treatment of various speech impairments Development of computer-generated speech Language scientists may investigate the ways children learn language Conduct cross-cultural studies of language and communication Study how languages are changing Examine language disabilities and the nature of language disorders in children and adults Hearing scientists investigate the nature of sound, noise, and hearing They may help develop equipment for hearing assessment Develop techniques for testing infants or those with physical or psychological impairments Develop and improve assistive listening devices Concerned with conservation of hearing and limiting environmental noise 17 A 18 In addition to the entry-level degree, what else audiologists need in terms of credentials? Educational requirements are 3-5 years of professional education beyond the bachelor’s degree ASHA CCC-A: Requires doctorate, professional experience, national exam State license is often needed and is frequently identical to ASHA CCC 19 D 20 In addition to the entry-level degree, what else to SLPs need in terms of credentials? Public schools require at least a bachelor’s degree, but most states require a master’s degree Requirements vary from state to state ASHA CCC-SLP: Requires master’s degree or doctorate, professional experience, professional development, national exam State license often needed and is frequently identical to ASHA CCC There may also be additional requirements for the state’s department of education school certification 18 21 B 22 What are the assumptions of evidence-based practice? Clinical skill grows from experience and current available data The SLP or audiologist seeks new therapeutic information to improve efficacy 23 A 24 What is involved in clinical decision-making? Combination of scientific evidence, clinical experience, and client needs 25 C 26 What are the three key elements of efficacy? It refers to an identified population, not specific individuals The treatment should be focused and the population should be clearly identified The research should be conducted under optimal intervention conditions, although actual clinical conditions may be less than ideal 27 B 28 What are some factors that affect clinical decision making? Clinician’s expertise, experience, attitude, and motivation Client/family values and characteristics Service delivery variables 29 A 30 Name and briefly describe four federal mandates affecting people with disabilities 1975: Education for All Handicapped Children Act (EAHCA) (Public Law 94-142): Mandated that a free and appropriate public education (FAPE) must be provided for all handicapped children between ages and 21 1986: Education of the Handicapped Amendments (Public Law 99-457): Extended age of those served to cover children between the ages of birth and years 1990: Individuals with Disabilities Act (IDEA): Addressed the multicultural nature of the U.S 2004: Established birth to programs as well as new early intervention services 31 A 32 B 33 B 34 C 19 CHAPTER TYPICAL AND DISORDERED COMMUNICATION Which of the following is the most accurate definition of the term 'communication'? a It is an exchange between senders and receivers b It is another word for speech c It is the process of self-expression d It is the exclusively human quality to talk to other humans is how cultural identity, setting, and participants influence communication a Communication b Sociolinguistics c Psycholinguistics d Multiculturalism Our cultural identity refers to a Our language b Our cultural communities c Both of the above d None of the above Grammar refers to a The rules of a language b The recognition by a native speaker of whether something is said “right” or “wrong” c Only the sound system of a language d The process of producing the acoustic representation of language Linguistic intuition refers to a The rules of a language b The recognition by a native speaker of whether something is said “right” or “wrong” c The sound system of a language d Being born with the ability to produce language What does it mean that languages are generative and dynamic? What are the three primary components of language? a Phonology, morphology, syntax b Form, content, use c Semantics, syntax, pragmatics d Phonology, phonotactic rules, morphology Form consists of a Phonology, morphology, syntax b Semantics, syntax, pragmatics c Phonology, phonotactic rules, morphology d None of the above Briefly explain how phonology and phontactic rules differ 20 10 Briefly explain morphology, morphemes, free morphemes, and bound morphemes 11 _ is how words are arranged in a sentence and the ways in which one word may affect another a Syntax b Semantics c Morphology d Pragmatics 12 Content consists of a Syntax and semantics b Pragmatics c Semantics d Morphology and phonology 13 refers to the content or meaning of language, whereas _ refers to the pieces of meaning that define a particular word a Morphemes, morphology b Morphology, morphemes c Semantic features, semantics d Semantics, semantic features 14 Use consists of a Syntax and semantics b Pragmatics c Semantics d Morphology and phonology 15 _ is how and why we use language; it varies with culture a Syntax b Communication c Speech d Pragmatics 16 Speech consists of articulation and fluency Briefly describe both 17 Voice can reveal things about the speaker and the message is a listener’s perception of how high or low a sound is, is the basic tone that an individual uses most of the time, and is the pitch movement within an utterance a Habitual pitch, pitch, intonation b Intonation, pitch, habitual pitch c Pitch, intonation, habituatl pitch d None of the above 18 About 2/3 of human meaning exchange is a Verbal b Vocal c Nonverbal d Nonvocal 21 19 _ refer to how you look, your clothes, your possessions, music you listen to, etc a Kinesics b Proxemics c Artifacts d Tactiles 20 refer to the way we move our body, or body language a Kinesics b Proxemics c Artifacts d Tactiles 21 Briefly (in 6-10 sentences) explain communication through the lifespan Be sure to touch on how infants learn language, potential complicating factors, and how we end up being competent communicators 22 refer to the physical distance between people as it affects communication a Kinesics b Proxemics c Tactiles d Chronemics 23 refer to touching behaviors a Kinesics b Proxemics c Tactiles d Chronemics 24 _ refer to the effect of time on communication a Kinesics b Proxemics c Tactiles d Chronemics 25 _ is the cause or origin of a problem, and may be used to classify a communication problem a Dialect b Etiology c Congenital disorder d None of the above 26 _ disorders are present at birth, whereas _ disorders are the result of illness, accident, or environmental circumstances later in life a Etiological, dialectal b Genetic, accidental c Congenital, acquired d Primary, secondary 27 Briefly describe disorders of form and potential etiologies 22 28 Briefly describe disorders of content and potential etiologies 29 Briefly describe disorders of use and potential etiologies 30 is a speech disorder caused by paralysis, weakness, or poor coordination of the speech musculature a Dysarthria b Apraxia c Dysphagia d Stuttering 31 _ is a speech disorder that is due to neuromotor programming difficulties a Dysarthria b Dysphagia c Aphasia d Apraxia 32 In disorders of , the smooth, uninterrupted flow of speech is affected a Articulation b Voice c Language d Fluency 33 Provide examples of the following: Fillers, hesitations, repetitions, and prolongations 34 What is stuttering? 35 What are some habits that can affect normal voice production? What are other causes? 36 _ is the term for excessive yelling, screaming, or loud singing Can result in hoarseness or another voice disorder a Vocal hygiene b Vocal abuse c Vocal strain d Vocal exertion 37 What is deafness? 38 Name three interventions for deafness 39 What are the ways in which hearing loss can be categorized? 23 40 A hearing loss that is caused by damage to the outer or middle ear a Conductive b Sensorineural c Mixed d None of the above 41 A hearing loss that is due to problems with the inner ear and/or auditory nerve a Conductive b Sensorineural c Mixed d None of the above 42 Describe auditory processing disorders Include symptoms, etiology, and population affected 43 Explain the following phrase: “Communication disorders are often secondary to other disabilities.” Give examples 44 _ is the number/percentage of people within a specified population who have a particular disorder or condition at a given point in time a Incidence b Prevalence c Impaired population d None of the above 45 What percentage of the U.S population has a communication disorder? a 1% b 4% c 9% d 17% 46 Impairments of speech-sounds and fluency are more common in than _ and more common in than _ a Children, adults, males, females b Adults, children, males, females c Children, adults, females, males d Adults, children, females, males 47 Describe the process of communication disorders assessment 48 distinguish(es) an individual’s difficulties from the broad range of possible problems a Etiological factors b Genetic markers c Predisposing causes d Diagnosis 24 49 _ refers to working with a client for a time to obtain a clearer picture of strengths and weaknesses a Response to intervention b Constraint-induced therapy c Diagnostic therapy d The cycles approach 50 A prognosis is a An informed prediction of an outcome b A trigger for a disorder c A factor that continues or adds to a problem d None of the above 51 _ tests yield scores that are used to compare a client with a sample of similar individuals a Dynamic assessment b Criterion referenced c Norm-referenced d All of the above 52 _ tests evaluate a client’s strengths and weaknesses with regard to particular skills a Dynamic assessment b Criterion referenced c Norm-referenced d None of the above 53 Name factors that influence intervention 54 What are five objectives of intervention? 55 Baseline data is a A measurement of the client’s accuracy before beginning intervention b The data from a normative sample c Test scores from norm-referenced tests d None of the above 56 What is the A, B, C, and D of behavioral objectives? 57 Behavior modification includes a Behavior and rewards b Stimulus and reinforcement c Extinguishing and punishing d None of the above 25 58 In incidental teaching, a The SLP provides a stimulus and reinforces the response if it is correct b The parent is responsible for providing therapeutic intervention after instruction c The SLP follows the client’s lead and teaches along the way d The child is encouraged to learn language skills from other children in the environment 59 What are the functions of support groups for communication disorders? 60 If therapy has been effective, the client is successful in a Generalizing the learned skills b Self-correcting c Experiencing automaticity d All of the above 61 Briefly describe the follow-up and maintenance process 26 CHAPTER – Answer key TYPICAL AND DISORDERED COMMUNICATION A B C A B What does it mean that languages are generative and dynamic? Generative means that each utterance is freshly created Dynamic means that languages change over time B A Briefly explain how phonology and phontactic rules differ Phonology is the sound system of a language, whereas phonotactic rules specify how sounds may be arranged in words 10 Briefly explain morphology, morphemes, free morphemes, and bound morphemes Morphology involves the structure of words Morphemes are the smallest grammatical units of a language Free morphemes may stand alone as words Bound morphemes change the meaning of the original words and can only be attached to free morphemes 11 A 12 C 13 D 14 B 15 D 16 Speech consists of articulation and fluency Briefly describe both Articulation is the way speech sounds are formed Fluency is the smooth, forward flow of communication, influenced by rhythm and rate Rate is the speed at which we talk Rate and rhythm are both components of prosody 17 D 18 C 19 C 20 A 27 21 Briefly (in 6-10 sentences) explain communication through the lifespan Be sure to touch on how infants learn language, potential complicating factors, and how we end up being competent communicators Infants must first learn the rudiments of communication and begin to master speech The early establishment of communication between children and caregivers fosters the development of speech and language, which influence the quality of communication This is complicated by physical, cognitive, and social development The key to becoming a communicator is being treated as one The process of learning speech and language is a social one that occurs through interactions of children and the people in their environment Every person’s speech and language continues to change until the end of life A competent communicator continues to adapt to changes in the language and in the communication process 22 B 23 C 24 D 25 B 26 C 27 Briefly describe disorders of form and potential etiologies Errors in sound use constitute a disorder of phonology Incorrect use of past tense or plural markers is an example of a disorder of morphology Syntactical errors include incorrect word order and run-on sentences May be due to sensory limitations, perceptual difficulties, limited exposure to correct models, etc 28 Briefly describe disorders of content and potential etiologies Limited vocabulary, misuse of words, or word-finding problems Difficulty understanding and using abstract language May be due to limited experience, concrete learning style, strokes, head trauma, or certain illnesses 29 Briefly describe disorders of use and potential etiologies Pragmatic impairments may stem from limited or unacceptable conversational, social, and narrative skills; deficits in spoken vocabulary; and/or immature or disordered phonology, morphology, and syntax Might include difficulty staying on topic, providing inappropriate or incongruent responses to questions, or continually interrupting the conversational partner 30 A 31 D 32 D 33 Provide examples of the following: Fillers, hesitations, repetitions, and prolongations Fillers: “er,” “um,” “ya know” Hesitations: unexpected pauses Repetitions: “g-g-g-go” Prolongations: “wwwwwwell” 34 What is stuttering? When these speech behaviors (fillers, hesitations, repetitions, prolongations) exceed or are qualitatively different from the norm or are accompanied by excessive tension, struggle, and fear 35 What are some habits that can affect normal voice production? What are other causes? Physical tension, coughing, throat clearing, smoking, and drinking alcohol Disease, trauma, allergies, neuromuscular disorders, endocrine disorders 28 36 B 37 What is deafness? When a person’s ability to perceive sound is limited to such an extent that the auditory channel is not the primary sensory input for communication It may be congenital or acquired 38 Name three interventions for deafness Three of the following: Total communication, assistive listening devices, cochlear implants, auditory training 39 What are the ways in which hearing loss can be categorized? Temporary or permanent In terms of severity, laterality, and type Severity may range from mild to severe (or profound) The loss can be bilateral or unilateral The type of loss can be conductive, sensorineural, or mixed 40 A 41 B 42 Describe auditory processing disorders Include symptoms, etiology, and population affected Individuals with APD may have normal hearing but difficulty understanding speech Difficulty keeping up with conversation, understanding speech in noise, discriminating and identifying speech sounds, and integrating speech with nonverbals Etiology is often unknown, but can be due to tumor, disease, or brain injury Can occur in children or adults May coexist with other disorders 43 Explain the following phrase: “Communication disorders are often secondary to other disabilities.” Give examples Children or adults may have a disorder that causes a communication disorder For example, children with cleft palate (primary) often have communication impairments associated with the cleft Individuals with cerebral palsy (primary) often have difficulty in various areas of speech 44 B 45 D 46 A 47 Describe the process of communication disorders assessment Systematic process of obtaining information from many sources, through various means, and in different settings to verify and specify communication strengths and weaknesses, identify possible causes of problems, and make plans to address them 48 D 49 C 50 A 51 C 52 B 53 Name factors that influence intervention Nature and severity of the disorder, the age and status of the client, environmental considerations, and personal/cultural characteristics of the client and clinician 29 54 What are five objectives of intervention? The client should show improvement and this should generalize What has been learned should be largely automatic The client must be able to self-monitor The client should make optimum progress in the minimum amount of time Intervention should be sensitive to the personal and cultural characteristics of the client 55 A 56 What is the A, B, C, and D of behavioral objectives? Actor: Who is expected to the behavior? Behavior: What is the observable and measurable behavior? Condition: What is the context or condition of the behavior? Degree: What is the targeted degree of success? 57 B 58 C 59 What are the functions of support groups for communication disorders? They can provide an avenue to practice what has been learned in therapy, share feelings about the disability, and maintain communication skills once formal treatment has been terminated 60 D 61 Briefly describe the follow-up and maintenance process Upon dismissal, the client or family should be encouraged to return if there is a need A regular follow-up schedule can be established Booster treatment may be provided if needed 30 ... Audiology (AAA): http://www.audiology.org American Speech-Language-Hearing Association (ASHA): http://asha.org Acoustical Society of America (ASA): http://asa.aip.org Peterson's Guide to Graduate and... Objectives ♦ A statement that specifies the target behavior in an observable and measurable way ♦ A: Actor: Who is expected to the behavior? ♦ B: Behavior: What is the observable and measurable behavior?... neurological disorders, and dementia may interfere with communication and swallowing Hearing loss may affect at least one quarter of older adults Evidence- Based Practice ♦ SLPs and audiologists