Transcript Speech and Language

OF GOD
Seyede Fateme Mohammadi
M.Sc
Speech & language pathology
Under the supervision:
Atabak Vosughi
DECEMBER 2014
Speech and Language Disorders
Definition
Speech-language pathology is the
treatment for the improvement or cure of
communication disorders, including
speech, language,
and swallowing disorders. The term used
to describe professionals in this discipline
is speech and language pathologist (SLP).
Description
The discipline of speech-language
pathology includes professionals that are
trained in the techniques, strategies, and
interventions designed to improve or
correct communication disorders.
Communication disorders include
disorders of speech, language, and
swallowing.
Language disorders include developmental
or acquired conditions that lead to
difficulties in understanding or producing
language. Speech-language pathologists
participate in the screening, assessment,
and treatment of patients who experience
one or a combination of these disorders.
Communication
Speech= audible representation of language.
Language= message that is contained in
speech.
Verbal
Communication
• Face-to-face.talephone.radio or
television & other media
Non-Verbal
Communication
• Gestures.how we dress or act-ever
our scent.Body language
Written
Communication
• Ietters.email.book.magazine.the
internet or via other media
Visualizations
• Charts.graphs.maps.logos & other
visulizations can communicate
messages.
“Copyright© Allyn & Bacon 2006”
The system of symbols that
individuals use for communication,
based on their culture
Expressive
Language
Receptive
Language
5 Components of Language
Phonology
Semantics
Pragmatics
Morphology
Content
Function
Syntax
Form
(usage)
Structure of language(linguistic
approach)

Phonology = rules regarding how sounds can
be used and combined.

Syntax = the way sequences of words are
combined into phrases and sentences.

Morphology = the form and internal structure
of words.

Semantics = the understanding of language.

Pragmatics = rules that govern the reasons for
communication as well as the choice of codes
to be used when communicating.
Definition
Language process of cognitive involves:




Memory.
Learning.
Message reception and processing.
Expressive skills.
Language delays= sequence of development is
intact but the rate is interrupted.
Language disorders= sequence of language
acquisition is not systematic or sequential.
Language development
Stages in developing skill's language.
 Crying, then cooing, growling and babbling by age
0-9(m).
 Different tones and vocal intensity.
 Echoing or mimicking responses.
 Words begin to become attached to people or
objects by age 12-15(m).
 Strings of two and three words by age 18-24(m).
 Basic syntactical structures by age 4.
 Six word sentences by age 5.
 Articulate nearly all the speech sounds correctly by
age 8.
Etiology of
Speech and Language Impairments
Ways to Classify Speech
and Language Impairments
Functional vs. Organic
Environmental
Physical
Congenital, Developmental,
or Acquired
Exist at birth
Emerge in childhood
Result from injury
13
Language Disorders
(for example):
Specific language impairment
Language delay
Aphasia
Central Auditory Processing
Disorder
Classification(According to cause):
.

Receptive language = difficulties in comprehending
what others say.

Expressive language = difficulty in formulating and
using language.
Aphasia = impairment of language comprehension,
formulation, and use due to injury, disease, or maldevelopment of the brain.
Receptive Language Problems
Encounters difficulty with understanding
oral presentation of information
Does not understand humor, figurative
language, or abstract thought
Expressive Language Problems
Limited use of vocabulary
 Searches for the right word
 Poor social language skills
 Hesitates to ask questions
 Jumps from topic to topic
 Topics chosen are concrete rather than
abstract, temporal, or spatial
 Repetitive and unspecific

Dimensions of Speech

Voice

Pitch, intensity,
quality
Resonance
 Articulation
 Fluency

Speech disorders can occur in all of these
areas
Speech disorders
Speech behavior that is sufficiently deviant from normal that it
attracts attention.
Fluency Disorders
Repeated interruptions, hesitations, or repetitions that seriously
interrupt the flow of communication.


Cluttering = speech that is overly rapid, disorganized, and
occasionally filled with unnecessary words.
Stuttering = flow of speech is abnormally interrupted by
repetitions, blocking, or prolongations of sounds, syllables,
words, or phrases.
Childhood apraxia of speech
Speech disorders
Articulation Disorders
Abnormality in the speech-sound production process
resulting in inaccurate or otherwise inappropriate
execution of the speaking act.
 Omissions.
 Substitutions.
 Additions.
 Distortions of certain sounds.
Causation:
Physical malformation, nerve injury, or brain damage.
 Cleft palate.
 Occlusion/malocclusion.
Defective learning of the speaking act.
Causation
“”
Speech disorders
Voice Disorders
Unusual or abnormal acoustical qualities in a
person’s speech.
 Subjectivity in determining voice normalcy.
 Problems are persistent when not treated.
Nasality, hoarseness, or breathiness.
Prevalence of
Speech Language Disorders
11-12 % of all students receiving special
education
2:1 ratio, boys to girls
Does not include students who receive
speech and language therapy as a related
service
Causes of Speech and Language
Disorders

Biological causes





Physical causes
Emotional causes
Brain injury
Heredity
Environmental
causes


Neglect or abuse
Poverty, malnutrition
Speech Assessments
Formal tests of articulation ( phonetic &
…)
Spontaneous conversation
samples(TOLD & …)
Developmental history
Examination of mouth, teeth, palate (oral
motor function)
Language Assessments
 Formal and informal assessments
 Samples of student’s written schoolwork
 Observations




What child talks about
How child talks about things
How child functions in context of community
How child uses language socially
Communication and Technology
Augmentative and alternative
communication (AAC)
 Unaided (low Tech): sign
language
 Aided (high Tech): depends on
equipment or materials
 Communication board
 Computer with speech
processor
 Word prediction software
Overview of Services Speech
therapy…. (PROCEDURE CPT CHARGE)
􀀻Swallowing Function
􀀻 Treatment of swallowing dysfunction and/or
oral function for feeding
􀀻 Evaluation of oral & pharyngeal swallowing
Function
􀀻 Motion fluoroscopic evaluation of swallowing
function by cine or video recording
􀀻 Flexible fiberoptic endoscopic evaluation of
swallowing by cine or video recording
􀀻 physician interpretation and report only
􀀻Flexible fiberoptic endoscopic evaluation,
laryngeal sensory testing by cine or video
Recording
􀀻 physician interpretation and report only
92526
92610
92611
92612
92613
92614
92615
􀀻 Flexible fiberoptic endoscopic evaluation of
swallowing and laryngeal sensory testing
􀀻 physician interpretation and report only
Speech and Language
􀀻 Evaluation of speech, language, voice,
communication, and/or auditory processing
􀀻 Treatment of speech, language, voice,
communication, and/or auditory processing
disorder,
individual
􀀻 group, two or more individuals
􀀻 Development of cognitive skills to improve
attention, memory, problem solving, direct
one-on-one patient contact by the provider;
each 15 minutes
􀀻 Sensory integrative techniques to enhance
sensory processing and promote adaptive
responses to environmental demands; each
15 minutes
92616
92617
92506
92507
92508
97532
97533
􀀻 Nasopharyngoscopy w/ endoscope
􀀻 Laryngeal function studies
􀀻 Evaluation of auditory rehabilitation status,
1st hour
􀀻 each additional 15 minutes
􀀻 PROCEDURE CPT CHARGE
􀀻 Auditory rehabilitation; pre-lingual hearing
Loss
􀀻 Auditory rehabilitation; post-lingual hearing
loss
􀀻 Assessment of aphasia with interpretation
and report, per hour
􀀻 Developmental testing; limited, w/
interpretation and report
􀀻 extended, with interpretation and report
92511
92520
92626
92627
92630
92633
96105
96110
96111
􀀻 Standardized cognitive performance testing
(eg, Ross Information Processing
Assessment) per hour of a qualified health
care professional’s time, both face-to-face
time administering tests to the patient and
time interpreting these test results and
preparing the report
􀀻 Laryngoscopy; flexible fiberoptic; diagnostic
􀀻 Laryngoscopy; flexible or rigid fiberoptic, with
stroboscopy
Augmentative and Alternative Communication
􀀻 Evaluation for use/fitting of voice prosthetic
device to supplement oral speech
􀀻 Evaluation for prescription of non-speech
generating augmentative and alternative
communication device
96125
31575
31579
92597
92605
􀀻 Therapeutic service(s) for the use of nonspeech
generating augmentative and
alternative communication device, including
programming and modification
􀀻 Evaluation for prescription for speechgenerating
augmentative and alternative
communication device; face-to-face with the
patient;
first hour
􀀻 each additional 30 minutes
􀀻 Therapeutic services for the use of speechgenerating
device, including programming
and modification
􀀻 Repair/Modification of AAC device (excluding
adaptive hearing aid)
92606
92607
92608
92609
V5336
Other Procedures
􀀻Otorhinolaryngological service or procedure
􀀻 Telephone assessment and management
service provided by a qualified nonphysician
health care professional to an established
patient, parent, or guardian not originating
from a related assessment and management
service provided within the previous seven
days nor leading to an assessment and
management service or procedure with the
next 24 hours or soonest available
appointment;
5-10 minutes of medical discussion
􀀻 11-20 minutes of medical discussion
􀀻 21-30 minutes of medical discussion
92700
98966
98967
98968
􀀻Online assessment & management service
provided by a qualified nonphysician health
care professional to an established patient,
guardian, or health care provider not
originating from a related assessment &
management service provided within the
previous 7 days, using the Internet or similar
electronic communications network.
Medical team conference with
interdisciplinary team of health care
professionals, face-to-face with patient and/or
family, 30 minutes or more; participation by
nonphysician qualified health care
Professional
􀀻 Medical team conference with
interdisciplinary team of health care
professionals, patient and/or family not
present, 30 minutes or more; participation by
nonphysician qualified health care
Professional
98969
99366
99368
Try to become not a
man of success, but try
rather to become a man
of value..
Albert Einstein
THANK YOU FOR
YOUR ATTENTION