Contents

vii

Preface xix

CHAPTER 1

Anatomy, Neuroanatomy, and Physiology of the Speech Mechanism 1

Respiration: Structures and Processes 1Respiration Patterns During Speech Production 1

Framework of Respiration 2

Muscles of Respiration 4

Phonation: Structures and Processes 7Larynx 7

Laryngeal Structures and Cartilages 7

Intrinsic Laryngeal Muscles 8

Extrinsic Laryngeal Muscles 9

Vocal Folds 11

Physiology of Phonation 11

Neuroanatomy of the Vocal Mechanism 13

Resonation and Articulation: Structures and Processes 14Fundamentals of Resonation 14

Fundamentals of Articulation 15

Neuroanatomy and Neurophysiology: The Nervous System 25

Neurons and Neural Transmission 26Anatomy and Physiology of Nerve Cells 26

Neural Transmission 26

The Peripheral and Autonomic Nervous Systems 28Peripheral Nervous System 28

Autonomic Nervous System 35

The Central Nervous System 37Basic Principles 37

The Brainstem 38

Reticular Activating System 40

Diencephalon 40

Basal Ganglia 40

The Cerebellum 41

The Cerebrum 42

Pyramidal System 46

Extrapyramidal System 48

Connecting Fibers in the Brain 50

The Cerebral Ventricles 51

Protective Layers of the Brain 51

Cerebral Blood Supply 52

Chapter Highlights 55

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

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Study and Review Questions 56References and Recommended Readings 58Study and Review Answers 59

CHAPTER 2

Physiological and Acoustic Phonetics: A Speech Science Foundation 61

Basic Principles and Defi nitions 61Defi nitions 61

Anatomy and Physiology: A Brief Review 62

Phonetic Transcription 63The International Phonetic Alphabet 63

Broad Phonetic Transcription 64

Narrow Phonetic Transcription 65

Production of Segmentals: Consonants and Vowels 65Consonants and Vowels: The Syllable as a Unit 66

Classifi cation Systems 67

Consonants 68

Vowels 73

The Effects of Context on Speech Sound Production 76Dynamics of Speech Production 76

Suprasegmentals 77

Speech Science: Physiological Phonetics, Acoustic Phonetics, and Speech Perception 78

Introduction to the Study of Sound and Acoustic Analysis of Speech 80Sound Wave Generation and Propagation 80

Frequency and Pitch 81

Amplitude and Loudness 81

Sound Pressure Level and Hearing Level 82

Introduction to the Acoustic Analysis of Speech 82

Chapter Highlights 84Study and Review Questions 85References and Recommended Readings 87Study and Review Answers 88

CHAPTER 3

Language Development in Children 91

Terms and Defi nitions 91Morphology 91

Syntax 92

Semantics 94

Pragmatics 95

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

Contents ix

Typical Language Development: Developmental Milestones 96Role of the Caregiver in Language Development 96

Birth–1 Year 97

1–2 Years 99

2–3 Years 102

3–4 Years 103

4–5 Years 106

5–6 Years 108

6–7 Years 109

7–8 Years 110

Development of Literacy Milestones 111

Language Development and Education in the School-Age Years 112

Theories of Language Development 113Behavioral Theory 113

Nativist Theory 115

Cognitive Theory 116

Information-Processing Theory 119

Social Interactionism Theory 120

Chapter Highlights 121

Study and Review Questions 122

References and Recommended Readings 128

Study and Review Answers 130

CHAPTER 4

Language Disorders in Children 133

Introduction to Children With Language Disorders 133Description of Language Disorders in Children 134

Risk Factors for Language Disorders in Children 134

Children With Specifi c Language Impairment 135Characteristics of Children With Specifi c Language Impairment 135

Children With Language Problems Associated With Physical and Sensory Disabilities 139Intellectual Disability 139

Autism Spectrum Disorders 140

Brain Injury 142

Children With Language Problems Related to Physical and Social–Environmental Factors 145Language Problems Related to Poverty 145

Language Problems Related to Neglect and Abuse 146

Language Problems Related to Parental Drug and Alcohol Abuse 147

Language Problems Related to Attention-Defi cit/Hyperactivity Disorder 149

Assessment Principles and Procedures 151Language Assessment: General Principles and Procedures 151

Assessment of Infants and Toddlers 154

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

x Contents

Assessment of Preschool and Elementary-Age Children 157

Assessment of Adolescents 160

Treatment Principles and Procedures 164General Principles 164

Specifi c Techniques 165

Augmentative and Alternative Communication 171

Chapter Highlights 174Study and Review Questions 175References and Recommended Readings 179Study and Review Answers 184

CHAPTER 5

Speech Sound Development and Disorders 187

Foundations of Articulation and Phonology 187Basic Defi nitions 188

Distinctive Features Paradigm 188

Place-Voice-Manner Paradigm 189

Acquisition of Articulatory and Phonological Skills: Typical Development 191Theories of Development 191

Infant Development: Perception and Production 193

Typical Articulation Development in Children 194

Overall Intelligibility 194

Typical Phonological Development in Children 196

Speech Sound Disorders 198General Factors Related to Speech Sound Disorders 198

Description of Articulatory Errors 199

Organically Based Disorders 200

Assessment of Speech Sound Disorders 204Screening 205

General Assessment Objectives 205

Related Assessment Objectives 205

Assessment Procedures 205

Specifi c Components of an Assessment 207

Scoring and Analysis of Assessment Data 208

Treatment of Speech Sound Disorders 210General Considerations in Treatment 211

Motor-Based Approaches 212

Linguistic Approaches 214

Core Vocabulary (Consistency) Approach 216

Phonological Awareness Treatment 216

Adults Who Speak English as a Foreign Language 218Principles of Assessment 218

Principles of Accent Training 219

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

Contents xi

Chapter Highlights 220

Study and Review Questions 221

References and Recommended Readings 225

Study and Review Answers 228

CHAPTER 6

Fluency and Its Disorders 231

Fluency and Stuttering: An Overview 231Defi nition and Description of Fluency 231

Defi nition and Description of Stuttering 232

Forms of Dysfl uencies 234

Theoretical and Clinical Signifi cance of Dysfl uencies 235

Incidence and Prevalence of Stuttering 235

Onset and Development of Stuttering 239

Associated Motor Behaviors 239

Associated Breathing Abnormalities 240

Negative Emotions and Avoidance Behaviors 240

The Loci of Stuttering 241

Stimulus Control in Stuttering 242

People Who Stutter and Their Families 244

Theories of Stuttering 245

Assessment and Treatment of Stuttering 249Assessment of Stuttering 249

Treatment of Stuttering 252

Neurogenic Stuttering 258Defi nition and Etiology of Neurogenic Stuttering 258

Description of Neurogenic Stuttering 259

Assessment and Treatment of Neurogenic Stuttering 259

Cluttering 260Defi nition and Description of Cluttering 260

Assessment and Treatment of Cluttering 261

Chapter Highlights 262

Study and Review Questions 263

References and Recommended Readings 266

Study and Review Answers 269

CHAPTER 7

Voice and Its Disorders 271

Vocal Anatomy and Physiology 271The Larynx 271

Voice Changes Through the Life Span 275

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

xii Contents

Vocal Pitch, Volume, and Quality 277Pitch 277

Volume 277

Quality 277

Evaluation of Voice Disorders 279Case History: Purposes and Goals 279

A Team-Oriented Approach 280

Instrumental Evaluation 280

Perceptual Evaluation 284

Disorders of Resonance and Their Treatment 287Hypernasality 287

Hyponasality 288

Assimilative Nasality 288

Cul-de-Sac Resonance 289

Treatment Principles 289

Disorders of Phonation and Their Treatment 290Carcinoma and Laryngectomy 290

Physically and Neurologically Based Disorders of Phonation 294

Abuse-Based Disorders of Phonation 302

Disorders of Loudness and Pitch 307

Psychogenic Voice Disorders 308

Gender Issues and the Voice 309

Chapter Highlights 311Study and Review Questions 312References and Recommended Readings 316Study and Review Answers 318

CHAPTER 8

Neurologically Based Communicative Disorders and Dysphagia 321

Aphasia 321Foundational Concepts 322

Defi nition and Classifi cation of Aphasia 323

Nonfl uent Aphasias 323

Fluent Aphasias 325

Subcortical Aphasia 328

Aphasia in Bilingual Populations 329

Assessment of Aphasia 329

Treatment of Aphasia 334

Alexia and Agraphia 338

Agnosia 338

Apraxia of Speech 339Defi nition and Distinctions 339

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

Contents xiii

Neuropathology of AOS 339

General Symptoms of AOS 340

Communication Defi cits in AOS 340

Assessment of AOS 341

Treatment of AOS 342

The Dysarthrias 343Defi nition of the Dysarthrias 343

Neuropathology of the Dysarthrias 343

Communicative Disorders Associated With Dysarthria 344

Types of Dysarthria 344

Assessment of the Dysarthrias 348

Treatment of the Dysarthrias 350

Dementia 351Defi nition and Classifi cation of Dementia 351

Dementia of the Alzheimer Type (DAT) 352

Frontotemporal Dementia (Including Pick’s Disease) and Primary Progressive Aphasia 353

Dementia Associated With Parkinson’s Disease 356

Dementia Associated With Huntington’s Disease 357

Infectious Dementia 357

Other Forms of Dementia 358

Assessment of Dementia 358

Clinical Management of Dementia 359

Right-Hemisphere Brain Damage 361Foundational Concepts 361

Symptoms of Right-Hemisphere Brain Damage 362

Assessment of Right-Hemisphere Brain Damage 363

Communication Treatment of Patients With Right-Hemisphere Brain Damage 364

Traumatic Brain Injury 365Defi nition and Incidence of TBI 365

Common Causes of TBI 366

Types and Consequences of TBI 366

General Assessment of Patients With TBI 367

Assessment of Communicative Defi cits Associated With TBI 367

Treatment of Patients With TBI 368

Swallowing Disorders 370Nature and Etiology of Swallowing Disorders 370

Normal and Disordered Swallow 370

Assessment of Swallowing Disorders 372

Treatment of Swallowing Disorders 373

Chapter Highlights 377Study and Review Questions 378References and Recommended Readings 382Study and Review Answers 389

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

xix v Contents

CHAPTER 9

Communication Disorders in Multicultural Populations 391

Foundational Issues 391Demographic Data 391

General Cultural Considerations 392

ASHA Guidelines Regarding Multicultural Issues 393

Speech–Language Characteristics of CLD Clients 394Dialects of American English 394

African American English 395

Characteristics of AAE Morphology, Syntax, and Articulation 396

Spanish-Infl uenced English 396

English Infl uenced by Asian Languages 402

Language Differences and Language Impairment 403Differentiating Language Differences From Language Impairments 404

Acquiring a Second Language 406

Conversational Informal Language Fluency and Formal Academic Language Fluency 408

Assessment of CLD Clients 410Legal Considerations 410

Considerations in the Use of Standardized Tests 411

Alternatives to Standardized Tests 413

Working With Interpreters in the Assessment Process 416

Treatment Considerations in Service Delivery to CLD Clients 417Children With Language Impairments 417

Prevalence and Incidence Rates of Medical Conditions and Communication Disorders 418

Potential Sociocultural and Linguistic Barriers to Service Delivery 419

Adults With Neurologically Based Disorders of Communication 420

Chapter Highlights 422

Study and Review Questions 423

References and Recommended Readings 428

Study and Review Answers 432

CHAPTER 10

Audiology and Hearing Disorders 435

Anatomy and Physiology of Hearing 436The Outer Ear 436

The Middle Ear 436

The Inner Ear 437

The Auditory Nervous System 438

Acoustics: Sound and Its Perception 439The Source of Sound 439

Sound Waves 440

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

Contents xv

Frequency and Intensity 440

Sound Pressure Level and Hearing Level 442

The Nature and Etiology of Hearing Loss 442Normal Hearing 442

Nature of Hearing Impairment 443

Conductive Hearing Loss 444

Sensorineural Hearing Loss 446

Mixed Hearing Loss 450

Auditory Nervous System Impairments 450

Assessment of Hearing Impairment 454Audiometry: Basic Principles 454

Pure-Tone Audiometry 455

Speech Audiometry 455

Acoustic Immitance 455

Other Methods 456

Hearing Screening 456

Assessment of Infants and Children 457

Interpretation of Hearing Test Results 457

Management of Hearing Impairment 460Communication Disorders of People With Hearing Impairment 461

Aural Rehabilitation: Basic Principles 462

Amplifi cation 463

Communication Training 467

Chapter Highlights 472Study and Review Questions 473References and Recommended Readings 476Study and Review Answers 478

CHAPTER 11

Assessment and Treatment: Principles of Evidence-Based Practice 479

Evidence-Based Practice in Speech–Language Pathology 479

Standard Assessment Procedures 480Screening 480

Case History 481

Hearing Screening 483

Orofacial Examination 483

Interview 484

Speech and Language Sample 484

Obtaining Related Assessment Data 486

Principles of Standardized Assessment 487Nature and Advantages of Standardized Assessment 487

Limitations of Standardized Tests 487

Prudent Use of Standardized Tests 488

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

xvx i Contents

Types of Scores in Standardized Assessment 489

Validity and Reliability of Standardized Tests 490

Rating Scales, Questionnaires, and Developmental Inventories 493Rating Scales 493

Questionnaires 493

Developmental Inventories 493

Alternative Assessment Approaches 494Functional Assessment 494

Client-Specifi c Assessment 495

Criterion-Referenced Assessment 496

Authentic Assessment 496

Dynamic Assessment 496

Portfolio Assessment 497

Comprehensive and Integrated Assessment 497

Treatment of Communication Disorders: Basic Concepts 498Treatment: Defi nition 498

A Treatment Paradigm for Communication Disorders 499

Basic Treatment Terms 499

Reinforcers and Reinforcement: Basic Defi nitions 503

An Overview of the Treatment Process 505Selection of Treatment Targets 505

Treatment Sequence 506

Maintenance Program 508

Follow-Up 508

Booster Treatment 509

A General Outline of a Treatment Program 509Cultural–Linguistic Considerations in Assessment and Treatment 510Chapter Highlights 512Study and Review Questions 513References and Recommended Readings 516Study and Review Answers 518

CHAPTER 12

Research Design and Statistics: A Foundation for Clinical Science 521

Essentials of the Scientifi c Method 521The Philosophy of Science: Basic Precepts 521

Validity of Measurements 523

Reliability of Measurements 524

Experimental Research 525Foundational Concepts 525

Group Designs 526

Single-Subject Designs 528

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

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Varieties of Descriptive Research 532Foundational Concepts 532

Ethnographic Research 536

Meta-Analysis 536

Evaluation of Research 536Internal Validity 537

External Validity 539

Levels of Evidence for Evidence-Based Practice 540

Data Organization and Analysis: Principles of Statistics 542Foundational Concepts 542

Statistical Techniques for Organizing Data 543

Types of Measurement Scales 544

Chapter Highlights 545

Study and Review Questions 546

References and Recommended Readings 550

Study and Review Answers 551

CHAPTER 13

Special Topics in Speech–Language Pathology 553

Counseling 553Qualities Necessary for Effective Counseling 553

Approaches to Counseling 554

Special Issues in Counseling 557

Reactions and Emotions Related to Communication Disorders 558

Defense Mechanisms 559

Medical Speech–Language Pathology 560Practice and Responsibilities of Speech–Language Pathologists 560

Medical Team Specialists and Their Roles 561

Infectious Disease Control 562

Working With HIV and AIDS Patients 563

Medical Imaging Techniques 565

Craniofacial Anomalies and Genetic Syndromes 566Craniofacial Anomalies 566

Cleft Lip 567

Cleft Palate 567

Genetic Syndromes 574

Medically Fragile Infants 581General Facts 581

Feeding and Oral–Motor Development 582

Chapter Highlights 584

Study and Review Questions 585

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.

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References and Recommended Readings 590Study and Review Answers 592

CHAPTER 14

Professional Issues 595

ASHA and the Professions 595The American Speech-Language-Hearing Association 595

The Professions of Speech–Language Pathology and Audiology 598

The Scope of Practice: Speech–Language Pathology 599

ASHA Accreditation 600

Issues in Certifi cation and Licensure 600Clinical Certifi cation 601

Speech–Language Pathology Assistants 602

State Regulation of the Profession 604

Legislative Regulation of the Profession 604Federal Legislation Affecting School Settings 605

Individuals With Disabilities Education Act (IDEA) 606

Federal Legislation Affecting Employment Settings 606

Federal Legislation Affecting Health Care Settings 607

Future Trends 608

Chapter Highlights 610Study and Review Questions 610References and Recommended Readings 613Study and Review Answers 613

APPENDIX

Study and Test-Taking Tips for the Praxis 615

Nature and Purpose of the Praxis 615Study Tips for Preparing for the Praxis 619General Tips for Taking the Praxis 619Understanding Computer-Generated Questions 621Conclusion 622References and Recommended Readings 622

Index 623

About the Authors 665

From An Advanced Review of Speech-Language Pathology: Preparation for Praxis and Comprehensive Examination, 4th Ed., by C. Roseberry-McKibbin and M. N. Hegde, 2016, Austin, TX: PRO-ED. Copyright 2016 by PRO-ED, Inc.