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DEVELOPMENTAL SPEECH DISORDERS - Coggle Diagram
DEVELOPMENTAL
SPEECH DISORDERS
SPEECH SOUND DISORDERS
(= trouble with perception, production,
or phonological representation
of speech sounds and segments)
FUNCTIONAL
(Idiopathic)
Phonology
(linguistic aspects)
Articulation
(motor aspects)
A lot of inconsistencies in how errors are produced!
Of unkown origin, often resolve themselves!
High comorbitity with language disorders
ORGANIC
Structural
(cleft palate)
Sensory/Perceptual
(hearing impairment)
Motor/Neurological
(true MSDs)
Planning: Apraxia
Execution: Dysarhria
FLUENCY DISORDERS
DEVELOPMENTAL STUTTERING
(developmental stuttering)
Underlying causes/correlates
speech movement disorder involving
dysfunction in basal ganglia
Attenuated connectivity in neural networks
which support timing and self-paced movement control
Different development of auditory-motor
and basal ganglia-thalamocortical networks,
affecting speech planning and execution processes
Cerebellum, anterior cingulate cortex,
supplementary motor area, right frontal operculum
Can stay into adulthood
Can (re)occur in neurodegenerative diseases
You can also have neurogenic stuttering
Can also occur secondary to neurologic disorders
Comorbidities: ADHD, ASS, language impairments, intellectual disabilities, seizure disorders, social anxiety disorder, speech sound disorders, other developmental disorders
Characterised by:
repetitions of sounds, syllables, and mono-syllabic words
prolongations of consonants
blocks = inaudible sounds, inability to initiate sounds
Sensorimotor
Atypical speech motor development
Less effective in the use of feedback for speech
Thus: ill-established speech-forward maps
Stuttering as a result from limited speech motor skills
performing and preparing complex motor actions
less flexible speech production system
Transitions between sounds are faulty (coarticultation!)
Quality of life
High risk of anxiety
Impairments, challenges, and distress
across several domains!
Rating of being less satisfied with their jobs
CLUTTERING
Higher than average frequency of disfluencies
Reduced intelligibility due toe exaggerated coarticulation
Rapid and/or irregular articulatory rate
Sounds like disorganised speech planning,
can also occur in adolescence, less anxiety
than stuttering, impact more on listener understanding
WHAT?
= an interruption of the flow of speaking,
characterised by atypical rate, rhythm, and
disfluencies (e.g. repetitions of sounds)
May be accompanied by:
excessive tension, physical strain
speaking avoidance and anxiety
struggle behaviours
secondary mannerisms (e.g. blinking)
CHILD SPEECH ACQUISITION
Production
1Y: (proto-)words, unmarked sounds and syllables
ORDER: whatever is easiest is acquired first!
(vowels, nasals, plosives < f, s, h < r th
8-12 M: variable babbling, language-specific!
4-8 M: babbling and vocal play
0-4 M: laughing, burping, crying, cooing
Perception
8 M: perception influenced by native language!
0-8 M:
able to identify parents' voices
able to identify their native languages
able to identify minimal phonetic differences
Babies as young universal listeners?
truly categorical perception?
merely auditory based?
Sensorimotor
(DIVA Model)
Reliance on auditory feedback!
Results in the development of speech sound maps!
Constant somatosensory changes influence development!
Requires the acquisition of sensory goals
CHILDHOOD APRAXIA OF SPEECH
(Motor Speech disorder)
= difficulty with planning, coordinating, producing and sequencing speech sounds (also known as developmental verbal dyspraxia), difficult to distinguish from other SSDs, has be a core impairment in planning in the absence of neuromuscular deficits!
ASHA
Lengthened and disrupted coarticulatory transitions
between sounds and syllables
Inappropriate prosody
(esp. lexical and phrasal stress)
Consonant-vowel errors in repeated
productions of syllables or words
Functional issues
Temperament
Social communication
Attention and focus
Vestibular function, fine-hand use, behavioural dysregulation, cognitive and learning problems, other oral motor issues
Clinical Contexts
Primary or secondary sign of children with complex neurobehavioural disorders of genetic origin (e.g. ASS)
As an idiopathic neurogenic speech sound disorder
in the absence of (e.g. ASS, Down Syndrome)
Causal association with known neurological etiologies
(e.g. stroke)
Comorbidities (neurodevelopmental disorders
e.g. SLI, ASS, ...)
Sensorimotor
= inability to transform phonological code into motor speech commands, due to deficits in feedforward contral and overreliance on feedback control
Either due to reduced somatosensory information or increased levels of 'neural noise'
Quality of life
Greatest impact on communication
Cognitive and learning problems
Behavioural dysregulation
Higher ratings of hyperactivity
and social problems in adolescents