SLP Orals Concepts Review

1. Aphasia

   Nota:

   • Acquired neurogenic language disorder (injury to the brain) that affects all language modalities: spoken language expression, spoken language comprehension, written expression, and reading comprehension. Often has relatively intact nonlinguistic cognitive skills, such as memory and executive function skills, although these may co-occur
   1. Nonfluent Aphasia
      1. Broca's Aphasa

         Nota:

         • Characterized by nonfluent speech, good comprehension, and poor repetition
         1. Agrammatism

            Nota:

            • Content words intact, most function words missing--common in Brocas
   2. Fluent Aphasia
      1. Conduction Aphasia

         Nota:

         • characterized by fluent speech, fair comprehension, and poor repetition
         1. Circumlocution
      2. Wernicke's Aphasia
   3. Paraphasia
      1. Phonemic: sound
      2. semantic: concept
2. Dementia
   1. Alzheimer's Disease

      Nota:

      • Progressive neurologic disease characterized by increasing dementia
   2. Vascular Dementia
   3. Lacunar state

      Nota:

      • A progressive neurologic disease cause by successive small infarcts in the midbrain and brain stem
3. Right Hemisphere Disorders
   1. Anosognosia

      Nota:

      • Denial of illness
4. Motor Speech Disorders
   1. Dysarthria

      Nota:

      • Types of several speech abnormalities caused by nervous system damage that affects movement or sensation within body parts involved in speech
      1. Flaccid Dysarthria

         Nota:

         • Atrophy & fasciculations, hypotonia & hypoactive gag, nasal regurgitation; phonatory/resonatory abnormalities: continuous breathiness,  vocal fold weakness, pronounced hypernasality (rapid deterioration of speech -- myasthenia gravis)
         1. Mixed Flaccid-Spastic
         2. Flaccid
         3. fasciculations

            Nota:

            • involuntary movements that cause visible movements of muscle fibers
      2. Spastic Dysarthria

         Nota:

         • Pathologic oral reflex, hyperactive gag, pseudobulbar affect, Slow rate, slow and regular speech AMRs, strained voice quality, excess and equal stress
         1. Mixed Flaccid-Spastic
         2. Spasticity

            Nota:

            • abnormally high levels of tension in resting muscles cuase by upper motor neuron damage
      3. Ataxic Dysarthria

         Nota:

         • Irregular articulatory breakdowns, irregular speech AMRs, dysprosody, automatic speech no better than other speech
      4. Hypokinetic Dysarthria

         Nota:

         • monopitch, monoloudness, reduced loudness and stress, rapid and blurred speech AMRs
         1. Hypokinetic
      5. Hyperkinetic Dysarthrias

         Nota:

         • Involuntary movements, tremor, chorea, dystonia, abnormal noises interrupting speech
      6. Unilateral Upper Motor Neuron Dysarthria

         Nota:

         • Mildness, rarely accompanied by resonance or voice abnormalities, no atrophy or fasciculations, Regular AMRs (even though breakdowns occur in speech)
   2. Apraxia

      Nota:

      • Disruption of volitional movement sequences in the absence of sensory loss, weakness, paralysis, or incoordination of the muscles involved in the movements. Usually a consequence of damage in the premotor cortex.
      1. Apraxia of Speech

         Nota:

         • A disorder of motor planning in the absence of impaired muscle control that affects voluntary positioning and sequencing of muscle movements for speech.
         • Regular AMRs, Irregular SMRs, better automatic speech, articulatory groping
         • Unlike aphasia, nonspeech modalities remain intact, attempt to correct articulatory errors, artic groping, errors influenced by artic complexity
      2. Oral Apraxia
5. TBI
   1. Agitation, selective, sustained, and alternating attention, memory impairments, visual processing impairments, executive function
   2. Language is irrelevant, confabulatory, curcumlocutory, tangential, fragmented, and noncohesive but linguistically acceptable
      1. Fail to recognize social conventions
      2. Comprehend literal and well structured, but struggle to comprehend nonstructured and non-literal
      3. Standard aphasia tests neglect organization of complex information, appreciation of nonliteral meanings, & pragmatics
6. Degenerative Diseases
   1. Amyotrophic Lateral Sclerosis
   2. Parkinson's Disease
   3. Huntingtons Disease

      Nota:

      • a hereditary  neurologic disease characterized by progressive chorea and dementia
7. Cerebral Vascular Accident

   Nota:

   • Temporary or permanent disruption of brain function due to interruption of its blood supply
   • Signs (all sudden onset): one-sided weakness/numbness, vision impairment, difficulty speaking/understanding, dizziness/falling, severe headache
   1. Can Cause Aphasia
   2. Can Cause Motor Speech Disorders

1. Subtle Phonological deficits

   Nota:

   •    Complex phonological production (Multi-syllabics, alliteration, nonwords) Phonological awareness Phonological memory & retrieval (Nonword repetition, Rapid Auditory Naming)
2. Semantic deficits

   Nota:

   • Restricted vocabulary Reduced depth of word meaning Poor semantic organization & categorization Less developed semantic relationships Difficulties with multiple meanings Difficulties with abstract & relational terms Indefinite vocabulary Difficulties w/ semantic  relations   
3. Syntactic deficits

   Nota:

   • May have generally delayed morphological development Marked difficulty with verbal morphology esp. verb tense and agreement, auxiliary verbs, and copula verbs even compared with younger normally developing children with similar MLU.
4. Pragmatic difficulties

   Nota:

   • For most SLI, pragmatic issues are very important, but often reflect difficulties rather than cause them Conversation:   Less out put overall and less Fluent, Assertive, Persuasive, Polite & Tactful, Clear & Complete Difficulties Realizing communication breakdowns, Clarifying, Requesting clarification 

Nota:

• Childhood disorder with core deficits in socialization, communication, play, and behavior.

1. Social behaviors
   1. Nonverbal behaviors
   2. No peer relationships
   3. lack of spontaneous seeking to share
   4. Lack of social/emotional reciprocity
2. Qualitative communication Impairments
   1. delay/lack spoken language
   2. impairment in initiating or sustaining conversation
   3. stereotyped / repetitive use of language
      1. Echolalia

         Nota:

         • tendency to repeat back what is said
   4. Lack of spontaneous make-believe play or social imitative play
3. Restricted repetitive and stereotyped patterns of behavior, interests and activities
   1. pattern of interest abnormal in intensity or focus
   2. Routines & Rituals
   3. stereotyped & repetitive motor mannerisms
   4. preoccupation with parts of objects

1. Types of Variables
   1. Independent variable

      Nota:

      • What is controlled or preexisting
   2. Dependent variable

      Nota:

      • that which is measured
   3. Independent Variable

      Nota:

      • That which is controlled or pre-existing
   4. Dependent Variable

      Nota:

      • that which is measured
2. Types of Studies
   1. Descriptive
   2. Correlational
   3. Semi-experimental
   4. Experimental
   5. Review
   6. Meta-Analysis
   7. Experimental

      Nota:

      • Random assignment of participants
   8. Quasi-experimental

      Nota:

      • Multiple groups or multiple measurements
   9. Nonexperimental
3. Types of Bias
   1. Selection Bias

      Nota:

      • the selection of individuals, groups or data for analysis such that proper randomization is not achieved, thereby ensuring that the sample obtained is not representative of the population intended to be analyzed
   2. Sampling Bias

      Nota:

      • when a sample is not representative
   3. Selection Bias

      Nota:

      • Experimenter or participant choices skew the experimental results
   4. Validity
      1. Internal Validity

         Nota:

         • Internal validity refers to how well an experiment is done, especially whether it avoids confounding (more than one possible independent variable [cause] acting at the same time). The less chance for confounding in a study, the higher its internal validity is.
      2. External Vallidity

         Nota:

         • the extent to which the results of a study can be generalized to other situations and to other people.
   5. Participation Bias

      Nota:

      • in which the results become non-representative because the participants disproportionately possess certain traits which affect the outcome. 
   6. Publication Bias

      Nota:

      • what is likely to be published, among what is available to be published
   7. Reporting Bias

      Nota:

      • reporting bias is defined as "selective revealing or suppression of information" by subjects
4. Subject Grouping
   1. Cohort
   2. Cross-Sectional
   3. Longitudinal
5. Descriptive
   1. Case-study
   2. Natural observation
   3. Survey
6. Correlational
   1. Case-control Study
   2. Observational Study
7. Semi-experimental
   1. Field Experiment
   2. Quasi-experimental
8. Review
   1. Literature review
   2. Systematic review
9. Meta-Analysis

1. Chi-squared

   Nota:

   • used with categorical data to see whether any difference in frequencies between your sets of results is due to chance
2. t-test

   Nota:

   • enables you to see whether two samples are different when you have data that are continuous and normally distributed. The test allows you to compare the means and standard deviations of the two groups to see whether there is a statistically significant difference between them.
3. Mann-Whitney U-test

   Nota:

   • It is used when comparing ordinal data (i.e. data that can be ranked or has some sort of rating scale) that are not normally distributed. Measurements must be categorical – for instance, yes or no – and independent of each other (e.g. a single person cannot be represented twice)
4. Spearman's Rho

   Nota:

   • tests the relationship between two variables in a dataset. If there is a statistically significant relationship, you can reject the null hypothesis, which may be that there is no link between the two variables.
   • NONPARAMETRIC
5. Pearson's r

   Nota:

   • Pearson r correlation is widely used in statistics to measure the degree of the relationship between linear related variables. 
   • For the Pearson r correlation, both variables should be normally distributed.  Other assumptions include linearity and homoscedasticity
6. ANOVA

   Nota:

   • tests for the difference in means between two or more groups
   1. MANOVA

      Nota:

      • Multivariate analysis of variance (MANOVA) is simply an ANOVA with several dependent variables, tests for the difference in two or more vectors of means.

1. Clinical Experience
2. Current, Quality Research
3. Client Needs and Preferences

Nota:

• An organized system of symbols shared among a group of people, with rules governing the form, content, and use of that language.

1. Domains
   1. Phonology

      Nota:

      • study of how sounds are put together to form words
      1. Phoneme

         Nota:

         • linguistically contrastive or significant sounds (or sets of sounds) of a language
      2. Allophone

         Nota:

         • one of two or more variants of the same phoneme
         • linguistically non-significant variants of each phoneme
   2. Morphology

      Nota:

      • Study of word structure, describes how words are formed out of the basic elements of language (called morphemes)
      1. Morpheme

         Nota:

         • Smallest meaningful unit of language
      2. Allomorph

         Nota:

         • any of the versions of a morpheme, such as the plural endings s (as in bats ), z (as in bugs ), and iz (as in buses ) for the plural morpheme.
   3. Syntax

      Nota:

      • Word order and overall structure of a sentence, the arrangement of words to form meaningful sentences, and a collection of rules that specify the ways and order in which words may be combined to form sentences in a particular language
   4. Semantics

      Nota:

      • The study of word meaning in a language. Involves the lexicon and the rules governing meaning relations among words
   5. Pragmatics

      Nota:

      • The use and purpose of language as it relates to knowing why to communicate what to say, how to say it, when to say it, and to whom to say it. 
2. .........................FORM.........................
3. >>>>>CONTENT>>>>>
4. *****USE*****
5. Difference

   Nota:

   • A communication difference is a variation of speech that is shared by a group of individuals within a particular region or culture. 
6. Disorder

   Nota:

   • When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder

1. Pretend Play
2. Assimilation
3. Accommodation
4. Theory of Mind
5. Communicative Intent

   Nota:

   • Language is intentional. Parents attribute intent when preintentional 
6. Joint attention
7. Perlocutionary 0-8 mos

   Nota:

   • Pre-intentional and pre-linguistic
   1. Illocutionary 8-12 mos

      Nota:

      • Intention but no language
      1. Locutionary

         Nota:

         • Intent and Language