: Publication

This introductory text is intended for undergraduate students who are interested in communication disorders and not just the professions of speech-language pathology and audiology. What is unique about this book is that each author addresses culturally and linguistically diverse aspects that impact each of the disorders. Not only will readers understand communication disorders, they will know what it means to have a communication/dialectal difference and how to differentiate between a difference and a true communication disorder. This information is infused into every chapter of the book. Study questions and websites of interest are also included in each of the chapters in case readers want to delve deeper into any of the chapter material.

Chapter One addresses the rigorous academic and clinical requirements to become practicing speech-language pathologists and audiologists. After that chapter, readers will delve into typical development with Chapters Two and Three. While learning about the disorders is important, readers are exposed to thorough chapters on the Anatomy and Physiology of the Speech Production Mechanism and Normal Speech-Language Development. The purpose for including these chapters is because readers must understand how the speech and language mechanism works so that typically developing individuals can communicate effectively. Only when readers understand what is typical will they be able to comprehend what is atypical.

With Chapters Four and Five, readers will gain exposure to the first two communication disorders: Speech Sound Disorders and Motor Speech Disorders. These two chapters address impairments with articulation and phonology. Chapter Six addresses Language Impairments exhibited by toddlers through adolescence.

Chapters Seven and Eight deal with Fluency and Voice Disorders. These are two very interesting chapters that address stuttering, cluttering, and the various types of voice disorders that individuals can exhibit throughout their lifespans. Chapter Nine addresses Language and Cognitive-Communication Disorders exhibited by adults. Chapter Ten deals with Pediatric and Adult Dysphagia (swallowing disorders). While it is not a communication disorder, I decided to include it as a separate chapter because our profession has evolved to include this as one of our roles.

Chapter Eleven addresses Hearing and Related Disorders. Hearing is instrumental in all aspects of typical and atypical speech and language development. The author addresses the anatomy and physiology of the ear, the types of hearing losses, hearing aid dispensing, cochlear implants, and assessment and intervention. Finally, I had to include a chapter on Alternative and Augmentative Communication. When individuals cannot communicate orally, they need another means to communicate. With the current advances in technology, individuals can communicate using alternative and augmentative devices.

All the chapters included in the book will expose readers to the various aspects of communication skills, communication differences, and communication disorders. After reading this book, you can decide if you want to become a practicing speech-language pathologist or an audiologist. Educators adopting this textbook will have access to PowerPoint™ slides for each chapter.

Preface xi

Acknowledgments xii

Contributing Authors xiii

Introduction to the Professions 1

Objectives 1

Introduction to Communication, Communication Disorders, and Dialectal Differences 2

Speech-Language Pathology: Academic and Clinical Requirements 6

Bilingual Speech-Language Pathology 10

Audiology: Academic and Clinical Requirements 10

Bilingual Audiology 13

National, State, and Student Organizations 13

Speech-Language Pathology and Audiology Assistants and Research Doctoral Degree (Ph.D.) 15

Demographics of the Professions 16

Employment Settings 19

Summary 20

Websites of Interest 20

References 20

Glossary 23

Study Guide Questions 25

Anatomy and Physiology of the Speech Production Mechanism 27

Objectives 27

Introduction 28

The Respiratory Subsystem: The Skeletal Framework 28

The Respiratory System: Functional Parts 31

The Phonatory Subsystem 35

The Articulatory and the Resonatory Subsystems 43

Neural Control in Speech and Language Production and Perception 52

Central Nervous System 54

Specialized Areas of the Cortex 59

Specialized Areas below the Cortex 61

Summary 64

Websites of Interest 65

References 65

Glossary 66

Study Guide Questions 71

Normal Speech-Language Development 75

Objectives 75

Introduction 76

Prelinguistic Language Stage 77

Emerging Language Stage 83

Developing Language Stage 96

Language for Learning Stage 104

Literacy 115

Cultural and Linguistic Issues and Considerations 117

Summary 121

Websites of Interest 124

References 124

Glossary 128

Study Guide Questions 133

Speech Sound Disorders 137

Objectives 137

Speech Sound Disorders 138

Incidence and Prevalence 139

Articulation Disorders 139

Phonological Disorders 142

Summary Regarding Articulatory Developmental Norms and Suppression of Phonological Processes 144

Risk Factors, Predictors, and Potential Causes of Speech Sound Disorders 145

Literacy Risk 148

Assessment 149

Intervention 158

Bilingual Children Diagnosed with Speech Sound Disorders 161

Summary 162

Websites of Interest 163

References 163

Glossary 168

Study Guide Questions 171

Motor Speech Disorders 175

Objectives 175

Introduction 176

The Dysarthrias 176

Apraxia 184

Childhood Apraxia of Speech 188

Etiologies of Motor Speech Disorders 190

Cultural and Linguistic Issues and Considerations 193

Assessment 195

Intervention 201

Summary 206

Websites of Interest 207

References 208

Glossary 210

Study Guide Questions 213

Language Impairment 215

Objectives 215

Language Impairment (LI) 216

Emergence and Prevalence of LI in Children 216

Language Characteristics of Children with LI 218

Advanced Language Skills in Children with LI 227

Language-Based Learning Disabilities 232

Nonlinguistic Skills in Children with LI 232

Other Disabilities that Impact Language 233

Genetic Syndromes 237

Role of the Speech-Language Pathologist in LI 241

Prevention of LI 242

Assessment of Children with LI 242

Treatment for Children with LI 245

Monitoring Progress in Children with LI 246

Cultural and Linguistic Considerations in LI 246

Summary 249

Websites of Interest 250

References 250

Glossary 259

Study Guide Questions 263

Fluency and Fluency Disorders 265

Objectives 265

Fluency, Disfluency, and Stuttering 266

Childhood-onset Stuttering 266

Theoretical Considerations and Models of Stuttering 274

Cultural and Linguistic Issues and Considerations 279

Assessment 280

Intervention 283

Other Fluency Disorders 287

Summary 290

Websites of Interest 292

References 293

Glossary 296

Study Guide Questions 299

Voice Disorders 301

Objectives 301

Introduction 302

Anatomy of the Larynx 303

The Laryngeal Cavities 303

The Laryngeal Musculature 305

Neurology of the Larynx 310

Phonation and the Acoustic Signal 314

Voice Disorders, Voice Differences, and Cultural-Ethnic Considerations 317

Prevalence of Voice Disorders 319

Examples of Voice Disorders 322

The Efficacy of Voice Therapy 333

Summary 334

Websites of Interest 335

References 336

Glossary 342

Study Guide Questions 347

Language and Cognitive-Communication Disorders in Adults 351

Objectives 351

Language and Cognition 352

Aphasia 356

Right Hemisphere Disorders 362

Dementia/Neurocognitive Disorder-Major 363

Traumatic Brain Injury 367

Cultural/Linguistic Issues and Considerations 369

Summary 371

Websites of Interest 372

References 372

Glossary 374

Study Guide Questions 377

Pediatric and Adult Dysphagia 381

Objectives 381

Why Include a Chapter on Swallowing? 382

Normal Swallow 383

Disordered Swallow 385

Roles of Speech-Language Pathologists 392

Cultural Issues and Considerations 398

Summary 400

Websites of Interest 400

References 400

Glossary 402

Study Guide Questions 405

Hearing and Related Disorders 407

Objectives 407

Overview 408

Anatomy and Physiology of the Ear 408

Normal Hearing Development 414

Types of Hearing Loss 420

Related Disorders and Potential Causes 425

Hearing Aid Dispensing 435

Cochlear Implant Hearing Loss Criteria 438

Cultural and Linguistic Issues and Considerations 441

Hearing Assessment 443

Intervention 448

Summary 450

Websites of Interest 451

References 452

Glossary 456

Study Guide Questions 461

Alternative and Augmentative Communication 463

Objectives 463

What Is AAC? 464

Myths Surrounding AAC 465

Types of AAC 466

Access Methods 470

Symbol Selection 473

Assessment 476

Vocabulary Selection 480

Intervention Strategies 481

Summary 484

Websites of Interest 485

References 487

Glossary 490

Study Guide Questions 493

Preface xi

Acknowledgments xii

Contributing Authors xiii

Introduction to the Professions 1

Objectives 1

Introduction to Communication, Communication Disorders, and Dialectal Differences 2

Speech-Language Pathology: Academic and Clinical Requirements 6

Bilingual Speech-Language Pathology 10

Audiology: Academic and Clinical Requirements 10

Bilingual Audiology 13

National, State, and Student Organizations 13

Speech-Language Pathology and Audiology Assistants and Research Doctoral Degree (Ph.D.) 15

Demographics of the Professions 16

Employment Settings 19

Summary 20

Websites of Interest 20

References 20

Glossary 23

Study Guide Questions 25

Anatomy and Physiology of the Speech Production Mechanism 27

Objectives 27

Introduction 28

The Respiratory Subsystem: The Skeletal Framework 28

The Respiratory System: Functional Parts 31

The Phonatory Subsystem 35

The Articulatory and the Resonatory Subsystems 43

Neural Control in Speech and Language Production and Perception 52

Central Nervous System 54

Specialized Areas of the Cortex 59

Specialized Areas below the Cortex 61

Summary 64

Websites of Interest 65

References 65

Glossary 66

Study Guide Questions 71

Normal Speech-Language Development 75

Objectives 75

Introduction 76

Prelinguistic Language Stage 77

Emerging Language Stage 83

Developing Language Stage 96

Language for Learning Stage 104

Literacy 115

Cultural and Linguistic Issues and Considerations 117

Summary 121

Websites of Interest 124

References 124

Glossary 128

Study Guide Questions 133

Speech Sound Disorders 137

Objectives 137

Speech Sound Disorders 138

Incidence and Prevalence 139

Articulation Disorders 139

Phonological Disorders 142

Summary Regarding Articulatory Developmental Norms and Suppression of Phonological Processes 144

Risk Factors, Predictors, and Potential Causes of Speech Sound Disorders 145

Literacy Risk 148

Assessment 149

Intervention 158

Bilingual Children Diagnosed with Speech Sound Disorders 161

Summary 162

Websites of Interest 163

References 163

Glossary 168

Study Guide Questions 171

Motor Speech Disorders 175

Objectives 175

Introduction 176

The Dysarthrias 176

Apraxia 184

Childhood Apraxia of Speech 188

Etiologies of Motor Speech Disorders 190

Cultural and Linguistic Issues and Considerations 193

Assessment 195

Intervention 201

Summary 206

Websites of Interest 207

References 208

Glossary 210

Study Guide Questions 213

Language Impairment 215

Objectives 215

Language Impairment (LI) 216

Emergence and Prevalence of LI in Children 216

Language Characteristics of Children with LI 218

Advanced Language Skills in Children with LI 227

Language-Based Learning Disabilities 232

Nonlinguistic Skills in Children with LI 232

Other Disabilities that Impact Language 233

Genetic Syndromes 237

Role of the Speech-Language Pathologist in LI 241

Prevention of LI 242

Assessment of Children with LI 242

Treatment for Children with LI 24

5 Monitoring Progress in Children with LI 246

Cultural and Linguistic Considerations in LI 246

Summary 249

Websites of Interest 250

References 250

Glossary 259

Study Guide Questions 263

Fluency and Fluency Disorders 265

Objectives 265

Fluency, Disfluency, and Stuttering 266

Childhood-onset Stuttering 266

Theoretical Considerations and Models of Stuttering 274

Cultural and Linguistic Issues and Considerations 279

Assessment 280

Intervention 283

Other Fluency Disorders 287

Summary 290

Websites of Interest 292

References 293

Glossary 296

Study Guide Questions 299

Voice Disorders 301

Objectives 301

Introduction 302

Anatomy of the Larynx 303

The Laryngeal Cavities 303

The Laryngeal Musculature 305

Neurology of the Larynx 310

Phonation and the Acoustic Signal 314

Voice Disorders, Voice Differences, and Cultural-Ethnic Considerations 317

Prevalence of Voice Disorders 319

Examples of Voice Disorders 322

The Efficacy of Voice Therapy 333

Summary 334

Websites of Interest 335

References 336

Glossary 342

Study Guide Questions 347

Language and Cognitive-Communication Disorders in Adults 351

Objectives 351

Language and Cognition 352

Aphasia 356

Right Hemisphere Disorders 362

Dementia/Neurocognitive Disorder-Major 363

Traumatic Brain Injury 367

Cultural/Linguistic Issues and Considerations 369

Summary 371

Websites of Interest 372

References 372

Glossary 374

Study Guide Questions 377

Pediatric and Adult Dysphagia 381

Objectives 381

Why Include a Chapter on Swallowing? 382

Normal Swallow 383

Disordered Swallow 385

Roles of Speech-Language Pathologists 392

Cultural Issues and Considerations 398

Summary 400

Websites of Interest 400

References 400

Glossary 402

Study Guide Questions 405

Hearing and Related Disorders 407

Objectives 407

Overview 408

Anatomy and Physiology of the Ear 408

Normal Hearing Development 414

Types of Hearing Loss 420

Related Disorders and Potential Causes 425

Hearing Aid Dispensing 435

Cochlear Implant Hearing Loss Criteria 438

Cultural and Linguistic Issues and Considerations 441

Hearing Assessment 443

Intervention 448

Summary 450

Websites of Interest 451

References 452

Glossary 456

Study Guide Questions 461

Alternative and Augmentative Communication 463

Objectives 463

What Is AAC? 464

Myths Surrounding AAC 465

Types of AAC 466

Access Methods 470

Symbol Selection 473

Assessment 476

Vocabulary Selection 480

Intervention Strategies 481

Summary 484

Websites of Interest 485

References 487

Glossary 490

Study Guide Questions 493

Mary Andrianopoulos, Ph.D., CCC-SLP is an Associate Professor at the University of Massachusetts Amherst. Her research interests and clinical expertise are in the areas of acquired Neurogenic Communication Disorders, such as Dysarthria, Apraxia of Speech, and neurologic voice disorders. She also studies neurodevelopmental communication disorders that affect prosody, such as Autism Spectrum Disorder. She utilizes subjective and quantitative acoustic methods to study the human voice with respect to differential diagnosis and rehabilitation of motor speech and voice disorders, including cultural and linguistic differences of voice and speech. She completed a two-year post-doctoral fellowship at the Mayo Clinic in Rochester, MN, is the author of several journal publications, book chapters, and training manuals, and has presented her research internationally. She was Fulbright Scholar in the Department of Cognitive Science at the University of Athens in Greece and served on the European Association for Quality Assurances (ENQA) in Higher Education.

Meher Banajee, Ph.D. CCC-SLP is an Associate Professor and Program Director of the speech-language pathology program of Louisiana State University Health Sciences Center. Her area of expertise includes working with young children with complex communication disorders (such as autism, cerebral palsy, and developmental delay). She has worked in the area of augmentative and alternative communication and assistive technology in educational and hospital settings including the Metropolitan Developmental Center, Children’s Hospital, Prentke Romich Company, and the Human Development Center, as Assistive Technology Coordinator for Region 1. She was the coordinator of ASHA’s Special Interest Group 12 in AAC. She was the topic chair for AAC ASHA convention in 2018 and 2019.

Jessica Bowers, M.S., CCC-SLP is a Lecturer and Director of Clinical Operations with the Department of Communication Disorders and the Speech-Language-Hearing Clinic at Texas State University. She teaches the undergraduate course Service Delivery in Communication Disorders and is a graduate clinical practicum supervisor. She has over 10 years’ experience as a speech-language pathologist primarily working with young children with developmental delays and sensory related feeding disorders. She began the Summer Intensive Feeding Program at Texas State University in 2015. Her research interests include family dynamics in the treatment process and family training programs for facilitating therapeutic techniques, specifically outcomes related to family involvement in therapy.

Rahul Chakraborty, Ph.D., CCC-SLP is an Associate Professor with the Department of Communication Sciences and Disorders at California State University Fullerton. He earned a Ph.D. from Purdue University in 2006. Dr. Chakraborty teaches undergraduate and graduate courses in voice science and research methods. Dr. Chakraborty’s primary area of research involves physiological underpinnings of adult bilingualism and interactions of sociolinguistic and psychophysical variables in adult bilinguals from the Indian and American subcontinents.

Celeste Domsch, Ph.D., CCC-SLP is an Associate Professor in the Department of Communication Disorders at Texas State University. She also serves as Graduate Advisor, and as Co-Director of the Texas State Communication Disorders Study Abroad Program in London and Peru. She earned a Ph.D. from Vanderbilt University in 2003. Dr. Domsch teaches undergraduate courses in Language Development and Language Disorders, as well as a graduate course in Speech Sound Disorders. She has 20 years of experience as a speech-language pathologist and has worked in hospital, private practice, and public-school settings. Her areas of research include the use of complex syntax by school-age children, as well as intervention to increase syntactic complexity in writing.

Valarie B. Fleming, Ph.D., CCC-SLP is Chair and Professor in the Department of Communication Disorders at Texas State University. She earned a Ph.D. from The University of Texas at Austin in 2007. Dr. Fleming teaches graduate courses in Aphasia and Related Disorders, Cognitive Rehabilitation, Communication and Aging, and Dysphagia. Her areas of research interest include cognitive and linguistic aging, mild cognitive impairment, and variables influencing access and utilization of health services in culturally and linguistically diverse populations. Her work has been funded by the Alzheimer’s Association and the American Speech-Language-Hearing Association.

Maria Diana Gonzales, Ph.D., CCC-SLP is an Associate Professor with the Department of Communication Disorders at Texas State University. She earned a Ph.D. from Ohio University in 1997. Dr. Gonzales teaches undergraduate Introduction to Communications Disorders courses and graduate courses in Adolescent Language Disorders and Multicultural Issues in Communication Disorders. She has over 25 years of experience as a bilingual speech-language pathologist. Her areas of research include studying emergent literacy skills, the grammaticality of narrative development and the efficacy of intensive intervention language programs with bilingual preschoolers who are typically developing, as well as those diagnosed with language disorders.

Connie L. Howard, Au.D., F-AAA, CCC-A is an Associate Professor with the Speech and Hearing Sciences Department at Lamar University. She earned a B.S. in biology and secondary teaching from Tarleton State University in 1996, an M.S. in audiology from Lamar University in 2000, and an Au.D. from Salus University in 2008. Dr. Howard is licensed by the state of Texas and has 17 years of clinical experience evaluating and treating hearing and balance disorders. She teaches undergraduate courses in Audiology II and Hearing Anatomy/Physiology, and graduate courses in Hearing Instruments I, Hearing Anatomy and Physiology of the Ear, Pharmacology for Audiologists, Pediatric Audiology and Genetics, and Hearing Conservation. Dr. Howard is the Externship Coordinator for fourth year audiology student placement. Her areas of research include hearing conservation, auditory processing, preventing middle ear trauma in the hyperbaric chamber, and development of a protocol for evaluating athletes with mild concussions.

Farzan Irani, Ph.D., CCC-SLP is an Associate Professor with the Department of Communication Disorders at Texas State University. He earned his Ph.D. in Communication Sciences and Disorders from Bowling Green State University. Dr. Irani teaches graduate courses in Motor Speech Disorders, Research Methods, Stuttering, and Voice Disorders. His area of research includes evaluating therapy outcomes for adolescents and adults who stutter, the effectiveness of telepractice with clients who stutter, and psychosocial aspects of stuttering and other communication disorders.

Jennifer L. Johnson, B.F.A., M.S., CCC-SLP is a Clinical Lecturer with the Department of Communication Disorders at Texas State University. She holds a Bachelor of Fine Arts in Musical Theatre Performance from Western Michigan University and a Master of Science in Communication Disorders from Texas State University. She received a certificate of Vocology from the University of Iowa and has extensive clinical experience in the area of voice. Ms. Johnson supervises graduate students in the Texas State University Speech-Language-Hearing Clinic and teaches a graduate voice disorders course. Her research interests include voice training and voice disorders, fluency, and communication differences including transgender voice and accent modification.

Linda Johnson, M.Ed., CCC-SLP is a Lecturer with the Department of Communication Disorders at Texas State University. She earned a master’s degree in speech/language pathology from Texas State University. She teaches undergraduate Clinical Aiding and Observation lab courses and supervises graduate students in the Texas State University Speech-Language-Hearing Clinic. She has worked with preschool, school-aged, and adult clients in a variety of treatment settings. Her areas of research interests include studying effective intervention for language/literacy skills and effective treatment interventions for dysphagia. Ranjini Mohan, Ph.D., CCC-SLP is an Assistant Professor with the Department of Communication Disorders at Texas State University. She earned her Ph.D. in Cognitive Neuroscience and Gerontology at Purdue University in 2016. She has extensive clinical experience working with adults with communication disorders both in the U.S. and in India. Her research interests include identifying age- and disease-related changes in communication and in understanding the neural bases of cognition and language in typically aging adults and those with neurogenic diseases.

Cecilia T. Perez, M.S., CCC-SLP is a Clinical Lecturer with the Department of Communication Disorders at Texas State University. She earned an M.S. from Texas State University in 2000. Cecilia supervises first year graduate student clinicians at the Texas State University Speech-Language-Hearing Clinic. She has over 18 years of experience as a speech-language pathologist and has practiced in the public school, home health, and early childhood intervention settings. Her areas of interest include literacy, early speech and language development, communication disorders within culturally and linguistically diverse populations, and the impact of poverty and homelessness on speech and language development.

Maria Resendiz, Ph.D., CCC-SLP is an Associate Professor with the Depart-ment of Communication Disorders at Texas State University. She earned her Ph.D. from the University of Texas at Austin in 2011. She has worked clinically as a bilingual speech-language pathologist in early childhood, private practice, and school settings. Currently, she teaches the Introduction to Communication Disorders course along with Articulation and Phonological Disorders at the undergraduate level. At the graduate level, she teaches courses in Bilingual Articulation and Phonological Disorders and Second Language Acquisition. Her current research interests include language development in bilingual individuals with typically developing language and language impairment, the evaluation of intervention programs, and the use of telepractice with international families.

Amy Louise Schwarz, Ph.D., CCC-SLP is an Assistant Professor with the Department of Communication Disorders at Texas State University. She earned a Ph.D. from The University of Texas at Dallas. Dr. Schwarz teaches undergraduate courses in Clinical Phonetics and Augmentative Alternative Communication, graduate courses in Language Assessment and Intervention in the birth to age 5 population, and an advanced seminar in Autism. She is both a speech language pathologist and a teacher of the deaf. Her areas of research include capturing clinical decision-making and studying emergent literacy practices used with prereaders who are typically developing in monolingual and bilingual populations, those who are hearing impaired, and those who are part of clinical populations.

Eric Swartz, Ph.D., CCC-SLP is an Associate Professor and Graduate Coordinator in the Communication Sciences and Disorders Program at Texas A&M University–Kingsville. He teaches graduate courses in stuttering as well as articulation and phonological disorders course, and supervises clinical practicum. He teaches undergraduate courses in voice and fluency disorders, an introduction to communication disorders, and diagnostics. His research interests revolve around the experiences of people who stutter, specifically therapy outcomes, effective coping, and acceptance of stuttering.

Jason Tipps, M.Ed., M.S., CCC-SLP is a Clinical Lecturer with the Department of Communication Disorders at Texas State University. He earned a Bachelor of Arts in Latin American Studies from The University of Texas at Austin, a Master of Education degree in Bilingual and Bicultural Elementary Education from Texas State University, and a Master of Science in Communication Disorders from Texas State University. Jason supervises graduate students in the Texas State University Speech-Language-Hearing Clinic and is the co-coordinator for the Bilingual Interest Group (BIG) and the Bilingual Cognate in the Department of Communication Disorders. His research interests include bilingualism/multiculturalism and second language acquisition. Jason has clinical experience treating pediatric and geriatric populations in out-patient, home health, and SNF settings.