Introduction to Communication Sciences and Disorders

Gary Weismer, PhD, is Oros-Bascom Professor Emeritus in the Department of Communication Sciences & Disorders, University of Wisconsin-Madison. He received his bachelor's and master's degrees from the Pennsylvania State University and his doctorate from University of Wisconsin-Madison in 1975. Dr. Weismer's research publications concern speech production in healthy talkers, as well as speech production and intelligibility phenomena in persons with motor speech disorders. Dr. Weismer served twice as Associate Editor for the Journal of Speech, Language, and Hearing Research (formerly the Journal of Speech and Hearing Research), as Associate Editor at Folia Phoniatrica et Logopaedica (FPL) from 1994 to 2011, and as Editor-in-Chief at FPL from 2011 to 2016. During his 35 years at University of Wisconsin-Madison, Dr. Weismer won several teaching awards, including for mentoring efforts in the University of Wisconsin-Madison Honors program. Dr. Weismer mentored 16 doctoral students during his career, many of whom are currently scientific leaders and university administrators. He is a past member of the Executive Board of the International Association of Logopedics and Phoniatrics, a fellow of the Acoustical Society of America, and past chair of his department. His research was supported by National Institutes of Health for more than 25 years. David K. Brown, PhD, has been Professor in the School of Audiology at Pacific University since it enrolled its first students in 2012. He is also the Director of the Audiology Simulation Lab (SIMLab) at Pacific. Previously, he was Director of Audiological Research for Cincinnati Children's Hospital Medical Center and Assistant Professor in the Departments of Otolaryngology and Communication Sciences and Disorders, where he is still an adjunct professor. For over 30 years, he has been a licensed and certified audiologist specializing in pediatrics. He teaches in the areas of acoustics, anatomy and physiology, cochlear implants, evoked potentials, otoacoustic emissions, pediatrics, and research fundamentals.

Preface
Acknowledgments
Reviewers

Chapter 1. Introduction to Communication Sciences and Disorders
Introduction: Communication Sciences and Disorders as a Discipline
Communication Sciences and Disorders: The Whole is Greater than the Sum of Its Parts
An Interdisciplinary Field
Translational Research
Does the Basic Science Work? Does the Clinic Work?
Evidence Based Practice
A Typical Undergraduate Curriculum
Who are the Professionals in Communication Sciences and Disorders?
Preparation for, and the Profession of, Speech-Language Pathology
Preparation for, and the Profession of, Audiology
Order of Chapters in the Text
Chapter Summary
References

Chapter 2. The Nervous System: Language, Speech, and Hearing Structures and Processes
Introduction
Central and Peripheral Nervous Systems
The Neuron
The Synapse
Tour of Gross Neuroanatomy
Frontal Lobe
Occipital Lobe
Temporal Lobe
Parietal Lobe
Hidden Cortex
Subcortical Nuclei
Brain Stem, Cerebellum, and Spinal Cord
The Auditory Pathways
The Dominant Hemisphere and the Perisylvian Language Areas
Arcuate Fasciculus (Dorsal Stream) and Ventral Stream
Functional Magnetic Resonance imaging (fMRI) and Speech and Language Brain Activity
Functional MRI (fMRI)
Diffusion Tensor Imaging (DTI)
Chapter Summary
References

Chapter 3. Language Science
Introduction
What is Language?
Language: A Conventional System
Language: A Dynamic System
Language is Generative
Language Uses Mental Representations
Language is Localized in the Brain
Components of Language
Form
Social Use of Language (Pragmatics)
Language and Cognitive Processes
Why
How
When
How do We Know the “How”?
Chapter Summary
References

Chapter 4. Communication in a Multicultural Society
Introduction
Why It Matters
Accent, Dialect, and Culture
Bilingualism and Multilingualism
Chapter Summary
References

Chapter 5. Preverbal Foundations of Speech and Language Development
Introduction
Some Preparatory Notes on Developmental Chronologies
0-3 Months: Production
0-3 Months: Perception and Comprehension
3-8 Months: Production
3-8 Months: Perception and Comprehension
8-12 Months: Production
8-12 Months: Perception and Comprehension
Gesture and Preverbal Language Development
Chapter Summary
References

Chapter 6. Typical Language Development
Introduction
12-18 Months
18-24 Months
Three Years (36 Months)
Multiword Utterances, Grammatical Morphology
Expanding Utterance Length: A Measure of Linguistic Sophistication
Grammatical Morphology
Typical Language Development in School Years
Metalinguistic Skills
Pragmatic Skill: Discourse
Complex Sentences
Sample Transcript
Chapter Summary
References

Chapter 7. Pediatric Language Disorders I
Introduction
Specific Language Impairment/Developmental Language Disorder
Language Characteristics of Children with SLI/DLD
Summary of the Language Disorder in SLI/DLD
Theories of SLI/DLD: What Causes the Disorder?
The Role of Genetics in SLI/DLD
Language Delay and Autism Spectrum Disorder
Language Characteristics in ASD
Language Delay and Hearing Impairment
Epidemiology of Hearing Loss
Language Characteristics in Hearing Impairment
Speech and Language Development and Hearing Impairment
Chapter Summary
References

Chapter 8. Pediatric Language Disorders II
Introduction
Criteria for a Diagnosis of Intellectual Disability
Down Syndrome (DS): General Characteristics
Epidemiology and the DS Phenotype
Language Characteristics in DS
Fragile X Syndrome (FXS): General Characteristics
Epidemiology of FXS
Language Characteristics in FXS
Chapter Summary
References

Chapter 9. Language Disorders in Adults
Introduction
Review of Concepts for Brain Speech Structure and Function for Speech, Language and Hearing
Cerebral Hemispheres
Lateralization of Speech and Language Functions
Language Expression and Comprehension are Represented in Different Cortical Regions of the Left Hemisphere
Connections Between Different Regions of the Brain
Perisylvian Speech and Language Areas of the Brain
Adult Language Disorders: Aphasia
Classification of Aphasia
Aphasia Due to Stroke: A Summary
Traumatic Brain Injury and Aphasia
Nature of Brain Injury in TBI
Language Impairment in TBI
Dementia
Brain Pathology in Dementia
Language Disorders in Dementia
Chapter Summary
References

Chapter 10. Speech Science I
Introduction
The Speech Mechanism: A Three-Component Description
Respiratory System Component (Power Supply for Speech): Functional Anatomy and Physiology
The Chest Wall and Vegetative Breathing
Speech Breathing
Clinical Applications: An Example
The Larynx (Sound Source for Speech): Functional Anatomy and Physiology
Laryngeal Cartilages
Laryngeal Muscles and Membranes
Phonation
Clinical Applications: An Example
Upper Airway (Shaper of Speech Sounds): Functional Anatomy and Physiology
Muscles of the Vocal Tract
Vocal Tract Shape and Vocalic Production
Velopharyngeal Mechanism
Valving in the Vocal Tract and the Formation of Speech Sounds
Voicing Contrasts for Consonants
Coarticulation
Clinical Applications: An Example
Chapter Summary
References

Chapter 11. Speech Science II
Introduction
The Theory of Speech Acoustics
The Sound Source
The Sound Filter
Vowel Sounds Result from the Combination of Source and Filter Acoustics
Resonant Frequencies of Vowels are Called Formants: Spectrograms
The Tube Model of Human Vocal Tract Makes Interesting Predictions and Suggests Interesting Problems
A Spectrogram Shows Formant Frequencies and Much More
Speech Synthesis
Speech Recognition
Speech Acoustics and Assistive Listening Devices
Speech Perception
The Perception of Speech: Special Mechanisms?
The Perception of Speech: Auditory Theories
Motor Theory and Auditory Theory: A Summary
Top-Down Influences: It’s Not All About Speech Sounds
Speech Intelligibility
Chapter Summary
References

Chapter 12. Phonetics
Introduction
International Phonetic Alphabet
Vowels and their Phonetic Symbols
Consonants and their Phonetic Symbols
Clinical Implications of Phonetic Transcription
Chapter Summary
References

Chapter 13. Typical Phonological Development
Introduction
Phonetic and Phonological Development: General Considerations
Phonetic and Phonological Development
Phonetic Development
Phonological Development
Typical Speech Sound Development
Determination of Speech Sound Mastery in Typically-Developing Children
Possible Explanations for the Typical Sequence of Speech Sound Mastery
Phonological Processes and Speech Sound Development
Phonological Development and Word Learning
Chapter Summary
References

Chapter 14. Motor Speech Disorders in Adults
Introduction
Classification of Motor Speech Disorders
Dysarthria
Subtypes of Dysarthria
The Mayo Clinic Classification System for Motor Speech Disorders
The Dysarthrias: A Summary
Apraxia of Speech
Chapter Summary
References

Chapter 15. Pediatric Speech Disorders I
Introduction
Speech Delay
Diagnosis of Speech Delay
Quantitative Measures of Speech Delay and Speech Intelligibility
Speech Delay: Phonetic, Phonological, or Both?
Additional Considerations in Speech Delay and Residual and Persistent Speech Sound Errors
Speech Delay and Genetics
Childhood Apraxia of Speech
CAS Compared with Adult Apraxia of Speech
CAS: Prevalence and General Characteristics
CAS: Speech Characteristics
CAS and Overlap with Other Developmental Delays
CAS and Genetics
Chapter Summary
References

Chapter 16. Pediatric Speech Disorders II
Introduction
Childhood Motor Speech Disorders: Cerebral Palsy
Types of Cerebral Palsy
Dysarthria in Cerebral Palsy
Childhood Motor Speech Disorders: Traumatic Brain Injury and Tumors
Traumatic Brain Injury
Brain Tumors
Treatment Options and Considerations
Chapter Summary
References

Chapter 17. Fluency Disorders
Introduction
Incidence and Prevalence of Stuttering
Genetic Studies
Diagnosis of Developmental Stuttering
The Natural History of Developmental Stuttering
Stage I: Typical Dysfluencies
Stage II: Borderline Stuttering
Stage III: Beginning Stuttering
Stage IV: Intermediate Stuttering
Stage V: Advanced Stuttering
Recovery of Fluency
Possible Causes of Stuttering
Psychogenic Theories
Learning Theories
Biological Theories
Acquired (Neurogenic) Stuttering
Symptoms of Neurogenic Stuttering Compared with Developmental Stuttering
Treatment Considerations
Chapter Summary
References

Chapter 18. Voice Disorders
Introduction
Epidemiology of Voice Disorders
Initial Steps in the Diagnosis of Voice Disorders
Case History
Perceptual Evaluation of the Voice
Viewing the Vocal Folds
Measurement of Basic Voice Parameters
Classification/Types of Voice Disorders
The Hypo-Hyperfunction Continuum
Phonotrauma
Organic Voice Disorders
Functional Voice Disorders
Neurological Voice Disorders
Pediatric Voice Disorders
Prevalence of Childhood Voice Disorders
Types of Childhood Voice Disorders
Treatment of Childhood Voice Disorders
Chapter Summary
References

Chapter 19. Craniofacial Anomalies
Introduction
Definition and Origins of Craniofacial Anomalies
Embryological Development of the Upper Lip and Associated Structures
Embryological Errors and Clefting: Clefts of the Lip
Embryological Errors and Clefting: Clefts of the Palate
Cleft Lip with or Without a Cleft Palate; Cleft Palate Only (Isolated Cleft Palate)
Epidemiology of Clefting
Speech Production in CL/P and CP
Diagnosis of VPI
VPI and Hypernasality
VPI, Consonant Articulation, and Speech Intelligibility
Clefting and Syndromes
Cleft Palate: Other Considerations
Chapter Summary
References

Chapter 20. Swallowing
Introduction
Anatomy of Swallowing
Esophagus
Stomach
The Act of Swallowing
Oral Preparatory Phase
Oral Transport Phase
Pharyngeal Phase
Esophageal Phase
Overlap of Phases
Breathing and Swallowing
Nervous System Control of Swallowing
Role of the Peripheral Nervous System
Role of the Central Nervous System
Variables That Influence Swallowing
Bolus Characteristics
Development
Age
Measurement and Analysis of Swallowing
Videofluoroscopy
Endoscopy
Client Self-Report
Health Care Team for Individuals with Swallowing Disorders
Chapter Summary
References

Chapter 21. Hearing Science I: Acoustics and Psychoacoustics
Introduction
Oscillation
Waveform
Spectrum
Waveform and Spectrum
Resonance
Psychoacoustics
Pitch
Loudness
Sound Quality
Chapter Summary

Chapter 22. Hearing Science II: Anatomy and Physiology
Introduction
Temporal Bone
Peripheral Anatomy of the Ear
Outer Ear (Conductive Mechanism)
Middle Ear
Inner Ear (Sensorineural Mechanism)
Chapter Summary
References

Chapter 23. Diseases of the Auditory System and Diagnostic Audiology
Introduction
Hearing Evaluation
Case History
Otoscopy
Immittance
Tympanometry
Acoustic Reflex Thresholds (ART)
Audiometric Testing
Physiological Responses
Vestibular Assessment
Audiometric Results
Type, Degree and Configuration of Loss
Hearing and Balance Disorders
Chapter Summary
References

Chapter 24. Assistive Listening Devices
Introduction
Hearing Aids
Steps in Selecting and Fitting a Hearing Aid
Types of Hearing Aids
Hearing Aid Components
Auditory Implantable Devices
Bone-Anchored Implant (BAI)
Middle Ear Implant (MEI)
Cochlear Implant (CI)
Chapter Summary
References

Chapter 25. Aural Habilitation and Rehabilitation
Introduction
Aural Habilitation
Assessment of Pediatric Communication Needs
Pediatric Intervention
Components of a Family-Centered Intervention
Auditory Training
Communication Options
Outcome Measures for Pediatrics
Aural Rehabilitation
Introduction to Aural Rehabilitation (AR)
Assessment of Communication Needs in Adults
Intervention
Speechreading
Adult Outcome Measures
Group Aural Rehabilitation
Chapter Summary
References

Index