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SPA 4476
Voice disorders & Fluency disorders
| Question | Answer |
|---|---|
| A voice disorder exists when a person's _____,_____, and ______ differ from those of similar age, gender, and cultural background | QUALITY PITCH LOUDNESS |
| A voice disorder exists when either the _____, the ______ function or both the laryngeal mechanism no longer meet the requirements | STRUCTURE FUNCTION |
| Quality | breathy, high pitch voice, strain |
| Pitch | too high or too low |
| Loudness | volume |
| mechanism | meet the voice demand |
| What is the role of the SLP? | Evaluation of the laryngeal Identify the voice disorder Develop a therapy plan |
| Sound PHONATION | is produced by the vibration of the vocal folds |
| Vocal folds PHONATION | lie within the laryngeal cavity |
| Larynx PHONATION | is the superior continuation of the respiratory passage |
| Airway protection | prevents foreign substances |
| Nonbiological function larynx | voice production (can produce sound without the vocal folds) |
| Biological function of the larynx | prevent certain substances into the lungs vocal folds close when we swallowing coughing closing off the airway to create a pressure |
| Laryngeal Elements | 1 bone 9 cartilages (3 pairs) Intrinsic and extrinsic laryngeal muscles |
| Voice Elements | Pitch-fo Loudness-amplitude Quality-harsh, breathy, hypernasal, hyponasal |
| Larynx | Lies superior in the respiratory passage way opposite approximately the 5th or 6th cervical vertebral body |
| Cartilages of the larynx are held together by ______ and ________ | MEMBRANES LIGAMENTS |
| 3 Types of Voice Disorder | ORGANIC NEUROGENTIC FUNCTIONAL |
| Organic | Systemic disease physical cause cancer, tuberculosis, papilloma |
| Neurogenic | damage to the central or peripheral nervous system or both innervates the larynx vocal folds not moving properly |
| Functional | voice disorders that occur from behaviors the way we use our voice (voice demand) sick(cough) clear your throat can't control in the environment poor vocal folds vibration from misuse or abuse boy going through maturity |
| Organic Physical cause example | web-band of tissue fuses b/w both vocal folds it could be congenital or acquired |
| Neurogenic Physical cause example | Paralysis lack of the vocal folds could be unilateral or bilateral |
| Functional Physical cause example | raising their voice Oscar the grouch |
| Organic Voice Problems | can affect how the vocal folds vibrate reduced vocal loudness short phrases (asthma) |
| Lung important for _______ and ____ ______ assessment= info about the contribution of the respiration and the larynx | respiration arrow dynamic method |
| Lower and upper airway causes...... | change and reaction to the larynx |
| Impairment in Phonation | Visualizing |
| neurogenic voice problems | caused within the peripheral and central nervous system |
| spinal cord injury, brainstem injury, cerebral palsy, CNS disease has a hard time with..... | respiration |
| Most common voice problem | unilateral paralysis one sided lack of innervation of the recurrent laryngeal nerve vagus nerve |
| lack of innervation cause | a vocal fold paralysis |
| any interruption of the recurrent laryngeal nerve can cause a | vocal fold paralysis |
| recurrent laryngeal nerve can regenerate... | function connects through the vagus |
| Spasmodic dysphonia common neurologic voice problem | voice strangled, great effort to push voice out over over-adducted pair of vocal folds; laryngeal stutter. Patient typically experiences normal voice when laughing or singing. |
| Spasmodic dysphonia | Neurologic disorder spasms in the laryngeal squeeze their voice out; they push and struggle to speak. To evade this struggle they whisper, talk on inhalation, speak with a lower or higher pitched voice or their voice sounds squeeky. |
| Dysphonia | any alteration in normal phonation |
| Laryngectomy | Total removal of larynx |
| TEST 3 forms of communication | 1. Electrolarynx (tool that goes on the throat) electromechanically shapes the oral cavity 2. Esophageal speech (burp speech) pulimary airflow you create the source supraglottic 3. TEP placed into the stoma becomes the speaking |
| What is Fluent Speech? | "the consistent ability to move the speech production apparatus in an effortless, smooth, and rapid manner resulting in a continuous, uninterrupted forward flow of speech." |
| Stuttering | "…characterized by involuntary repetitions of sounds and syllables, sound prolongations, and broken words [pauses]." |
| Forms of Stuttering | 1. Developmental Stuttering 2. Neurogenic Stuttering 3. Cluttering |
| Developmental Stuttering | Begins in preschool years. general trends regarding stuttering behaviors, reactions to stuttering, and conditions that seem to promote stuttering |
| Neurogenic Stuttering | neurological disease or trauma; differs from developmental in many ways |
| Cluttering | Characterized by rapid bursts of unintelligible speech A problem in speech rhythm and rate. |
| Monosyllabic whole-word repetitions | he-he-he-he-he hit me |
| Sound repetitions | b-b-b-ball |
| Syllable repetitions | ba-ba-ba-ba-ba-baseball |
| Audible prolongations | sssss-snow |
| Inaudible prolongations | g----irl |
| Phase One | The preschool years, ages 2-6 stuttering tends to be episodic, characterized by periods of stuttering interspersed with periods of relative fluency |
| Phase Two | Early elementary years Stuttering has progressed. Disfluencies are chronic (habitual) without many periods of fluency. |
| Phase Three | 8 years to young adulthood Stuttering in response to specific situations. Common situations include telephone use, strangers, speaking to groups, complex explanations. |
| Phase Four | Now, stuttering advanced. Fearful anticipation of stuttering now apparent. Speaker fears certain sounds, words, situations. |
| Organic Theory | Proposes a physical cause. Cerebral dominance theory has been the most common organic theory: Cerebral dominance theory: AKA "handedness theory" |
| Behavioral Theory | Proposes stuttering behaviors as learned responses "Diagnosogenic" theory |
| Psychological Theory | Stuttering as neurosis: Stuttering as a neurotic manifestation of unconscious needs and internal conflicts. Psychotherapy recommended to treat stuttering. |
| Differences nodules | bilaterally |
| Unilaterally polyps | unilaterally |
| Normal Disfluencies | Revisions (He can't—he won't play baseball) are the dominant type at 3 years of age Normal adult disfluencies include: whole word repetitions, interjections (fillers, place-holders), phrase repetitions, sentence revisions |
| Therapy for Stuttering | Fluency-shaping techniques Stuttering modification techniques |
| what happens when we are not fluent? | whole word repetitions, (fillers, place-holders), phrase repetitions, sentence revisions |
Created by:
jnater
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