Communication across the life span

1. Communication across the life span February 15, 2013

2. Communication • Communication is a characteristic of humans in all cultures and in all stages of development • Typically we use language to communicate • Communication can occur without some type of verbal exchange • However, communication can occur using interactions via gestures, facial expressions and body language • Language development has a biological basis and is specifically preprogrammed in human beings • It is also inter related to other domains such as cognition, psychosocial and motor development

4. Speech • Speech is the verbal mode used for communication • Composed of individual sounds called phonemes • Allophones are variations of the same phoneme • Phonological rules are used to combine phonemes in the correct order in order to produce words • Word /cat/ is a combination of three sounds /k/, /q/, /t/ • Three sounds are combined using phonological rules (consonant is usually followed by a vowel sound, vowel is the nucleus of a syllable, etc.) • Helps us to generate thousands of words with different meanings

5. Voice and articulation • Vocal folds vibrate to create a complex tone that is composed of many frequencies • Movements of the lips, tongue and teeth together with breath support produce various sounds • Try out two sounds – one voiced and the other voiceless • Articulation is the manner in which the oral and nasal cavities come together to modify the air stream that comes from the larynx • Speech can be analyzed in three ways: • Perceptual: Use of our auditory skills to receive and analyze messages • Physiology helps to us to understand production features of various allophones • Acoustical study utilized to quantify parameters of sound frequency, intensity and time

6. The respiratory mechanism • Pulmonary system and the chest wall system • Pulmonary system • Lungs and airways • Upper respiratory system (oral and nasal cavities) • Lower respiratory system (larynx, bronchial system and the lungs) • Chest wall system • Rib cage, abdomen and diaphragm • http://www.youtube.com/watch?v=HiT621PrrO0&feature=player_embedded#!

8. Larynx • Cartilaginous tube • Connects to the respiratory system (trachea and lungs) inferiorly • Superiorly to the vocal tract and oral cavity • Position important because of its relationship and integration between three subsystems • Pulmonary power house • Laryngeal valve • Supraglottic vocal tract resonator • Lungs are the power supply for aerodynamic (subglottic tracheal) pressure that blows vocal cords apart – sets them into vibration • Vocal cords oscillate in a series of compressions and rarefactions • Modulate the subglottic pressure or transglottal pressure of short pulses of sound energy to produce human voice • http://www.youtube.com/watch?v=Z_ZGqn1tZn8

10. Laryngeal system • Vocal cords can be moved in several ways • Spread apart (abducted) • Gap between the vocal cords called the glottis • Air moves in and out freely when gap is wide open • Sounds harsh and noisy when somewhat constricted • Pulled together (adducted) • Airway is blocked • Air pressure builds up under the vocal cords causing them to bulge up • Eventually blown apart to release a puff of air • Vocal folds fall back due to elastic recoil or aerodynamic effect • Air pressure decreases when speed of airflow increases (Bernoulli effect) • Tensed or stretched

11. Laryngeal system • Vibrating vocal cords produce puffs of air • Rate of vocal cord vibration (fundamental frequency) • 125 per second in males • 250 per second in adult females • 500 per second in young children (infants) • Measured in Hertz (one complete cycle of vibration per second) • Fundamental frequency changes constantly to produce intonation • Faster they vibrate the higher the pitch or frequency

12. Laryngeal system • Greater the tension in the vocal cords • Thinner the vocal cords • Higher the frequency • Decrease in tension in the vocal cords • Thicker the vocal cords • Lower the frequency • The amount of air released will also change the loudness • Greater the amount air released softer the tone • Lesser the amount of air released the louder the tone • Forceful adduction increase the loudness

13. Supralaryngeal system • Sound from the larynx has to be shaped or modulated by the supralaryngeal system • Complex sound is composed of a series of simple periodic sounds (pure tones) called harmonics • Each harmonic has a unique frequency and amplitude • Frequency is measured in cycles per second or Hertz (Hz) • Lowest harmonic is the fundamental frequency (Fo) – represents the rate of vocal cord vibration • Each subsequent harmonic is 120 Hz higher – 240 Hz, 360 Hz, etc.

14. Supralaryngeal system • Amplitude represented in decibels (dB) of sound pressure level or intensity level • Amplitude harmonics vary in a predictable manner • Fo has the highest amplitude • Harmonics drop off at 12dB per octave • 12 dB drop between the fundamental frequency and first harmonic • Graph (amplitude spectrum) shows amplitude and frequency of each harmonic

15. Supralaryngeal system • Sound traveling through the upper airways (supralaryngeal or vocal tract) is modulated by shape and size of the tract • Some harmonics are amplified and some reduced (damped) • Humming sound of phonation acquires overtones called resonant or formant frequencies • As the cavity changes to form different sounds resonance or formants also change

16. Supralaryngeal system

17. Supralaryngeal system • Articulation • Process of forming sounds by movement of the articulators • Vocal or supralaryngeal tract made up of tubes from the larynx to the opening of the mouth and nose • Oral cavity – lips to the back of the throat – changed by the articulators • Nasal cavity – from the nares to the velopharynx – fixed • Pharyngeal cavity between the vocal folds to the nasal cavity

18. Supralaryngeal system

19. Supralaryngeal system • Pharyngeal oral-nasal system • Pharynx • Divided into 3 cavities • Laryngopharynx, oralpharynx and nasopharynx • Direction of sound determined by the position of the velum (soft palate) • Velopharynx – velum (extension of the hard palate) and pharyngeal walls • Open position – nasal radiation for nasal sounds • Closure of the velopharyngeal port for oral sounds • Upward movement of the velum • Inward movement of the pharynx • Different types of movements • Cleft palate or short palate causes hypernasality

21. Supralaryngeal system • Articulation • Coordination of fixed (teeth, alveolar ridge, hard palate) and mobile (tongue, jaw, and soft palate) articulators • Upper jaw or maxilla and the mandible have teeth which help to produce sounds such as /’/ /;/ /f/ /v/ • Alveolar ridge –bony shelf of the maxilla help to produce sounds such as /t/, /d/, /z/ and /s/ • Hard palate which extends from the alveolar ridge helps to produce /c/ /y/, /j/,/./

22. Suprapharyngeal system • Oral cavity • Lower jaw or mandible – moves the lower lip and tongue • Tempromandibular joint – hinge like movement • Up and down as well as slightly forward and backward and side to side • Produces vowel sounds such as /e/, /i/, /o/ • Movements produced by muscles • Temporalis • Masseter • Geniohyoid • Mylohyoid

23. Suprapharyngeal system • Tongue • Most important articulator • Shortened, lengthened, widened, narrowed, flattened and thickened • No skeleton – skeletal support from the hyoid bone and the jaw • Attached to the palate, pharynx and the epiglottis • Capable of complicated movements due to its own musculature • Body – main bulk – vowel production • Tip – apex – 50% of consonants • Blade – behind the tip – small number of sounds (/c/) • Dorsum – back – velar sounds • Root – front wall of the pharynx

24. Supralaryngeal system • Oral cavity • Lips • Upper and lower lips contribute by opening and closing the oral cavity • Lower lip moved by the jaw – greater movement than the upper lip • Allows production of sounds such as /p/, /b/, and /m/

25. Phonetics • Four or five descriptors typically used to classify consonants • Voicing • Nasality • Manner of articulation • Place of articulation • Secondary articulation • /n/ is a voiced, alveolar, nasal, stop • /f/ is a unvoiced, labiodental, fricative • Vowels are classified according to 3 characteristics • Height – high, mid, low • Frontness/backness – front, central or back • Lip shape – spread, rounded, normal • All vowels are voiced,

26. Phonetics • Suprasegmentals • Classified according to: • Loudness • Pitch • Duration • Subject (noun) vs. subject (verb) • Emphasis called stress • Intonation used to differentiate between a statement and a question (it’s a good time vs. it’s a good time?)

27. Language • Complex and dynamic system of conventional symbols that is used in various modes for thought and communication • Langauge evolves within specific historical, social, and cultural contexts • Language is rule governed • Phonology • Morphology • Syntax • Semantic • Pragmatic • Language learning is determined by biological, cognitive, psychosocial and environmental factors • Effective use of language requires understanding of human interaction (sociocultural roles, nonverbal cues and motivation) • Multifaceted behavior that is under constant change • New advances in technology • Dialects

28. Language structure • Phonology is the rules that govern combination of phonemes or sounds • Morphology is the study word structure • Free morphemes (e.g., dog) • Bound morphemes (e.g., s) • Syntax of the word order of language • Subject followed by a verb which is followed by an object • Semantics • Referential meaning – meaning assigned to individual words (the word car induces a mental picture of a car), adult vocabulary of 80,000 words • Relational meaning – combination of referents • Figurative meaning

29. Language structure • Pragmatics – rules for talking or the rules for what we say and how we say it • Speech act conforms to the context • Initiation • Turn taking • Commenting • Requesting • Termination • Repair

30. Prelinguistic development • Characterized by child’s exploration of his environment • Cognitive, motor, and social domains develop in parallel to this development • At the end of this period the child learns to use words as referents (abstract symbols of actual referents) • First three months • Human voice calming effect when the infant is upset • Caregivers constantly provide stimulation in the form of auditory and visual input • Develops into an early schema • Crying is used to signal hunger or discomfort which will result is satisfaction of the need (caregiver will produce a bottle) • Vowels emerge during periods of satisfaction

31. Prelinguistic development • Vowels are combined with back of throat sounds (/k/ and /g/) in the second month (called vocal play or cooing) • Prolongation of vowel sounds appears next • Turning head towards a voice and responding vocally to the speech of caregivers is also observed • http://www.youtube.com/watch?v=k2YdkQ1G5QI • http://www.youtube.com/watch?v=Btg9PiT0sZg&feature=related

32. Prelinguistic development • Fourth to the twelfth month • http://www.youtube.com/watch?v=EPKum-YIWnw&feature=related • Consonant vowel combinations are strung together and practiced during times of comfort and content (babbling) • Sounds produced are not specific to the native language • Emergence of suprasegmental features (rhythm and flow) • Five to nine months the child expands on prelinguistic behavior

33. Prelinguistic development • Variegated babbling replaces the repetitive babbling • http://www.youtube.com/watch?v=xaZSnwD_Zik&feature=related • Echolalia emerges towards the end of this period • Child attempts to imitate the caregiver’s utterances • http://www.youtube.com/watch?v=qS3GVCcIIKg&NR=1 • Meaning is not associated with these imitations • Infant understands angry intonations, his name and some words • They start to pay attention to conversation

34. Language development • 12 months to 48 months • Single word utterances • First words emerge at approximately 12 months of age • Child uses single words (holophrases) just as competent speakers do to convey meaning relations • Relations are context based and the meaning is about the here and now • Object names and actions (e.g., eat for hungry) • Consonant vowel or vowel consonant combinations • Continues until 18 months of age • Understands more words than he produces • First 50 words are holophrases • Not aware of the single sounds that form the words • After 50 words they become more aware of the phonology and start to combine sounds in a variety of ways to form different words

35. Language development • Two word utterances • 18 months to 24 months • Best studied within the context the utterances are produced (mommy shoe may mean different things in different contexts) • Morphological stage • Marked by expansion in utterance length • 27 to 30 months • Begin to produce phrases (my doggie) and clauses (my doggie eat) • Preparation for adult sentence structure (agent-action-object) • Inflections also appear to change the type and the meaning of the sentence • Caregivers are constantly stimulating the infant • Caregivers speak with less complex language with children • They provide expansions

36. Language Development • Development of syntax • 31 to 34 months • Continue to add detail • Development of questions and imperatives (with appropriate word order) • Engage in conversations • Take turns, repair may or may not be successful • Sentence embedding • Phrases and clauses are embedded within each other to create more complex utterances (put it under the table or I like the boy who helped) • Pragmatics continues to improve (more turns during conversation and the meaning of pausing - to pause for the communication partner to respond and that it is signal for the end of the utterance)

37. Language development • Co-joining sentences • Complete utterances • Begin to consider the perspective of the listener • Continue to embed and start cojoining sentence (I like cookies and I ate them all) • Refining language skills • School experience places the child in a different environment with different interactions • Cognition continues to play a role • Formalizes the language channels by learning to read, write, and spell • Uses language now to learn other concepts • Development of metalinguistics (assess phonological, syntax and semantic rules)

38. Communication disorders • Developmental delays or acquired problems • 17% have communication disorders • 11% have some type of hearing loss • 6% a speech disorder • Speech disorder includes disorders of voice, articulation and fluency • Language disorder refers to comprehension and production of language

39. Classification of communication disorders

40. Language disorders • Language disorders in children • Difficulty in acquiring language • Cognitive impairment/developmental delay • Language impairment of varying degrees • As they grow the gap between their chronological age and language age continues to expand • Expressive language is shorter in length and less complex • Semantics and pragmatics are also a problem

41. Language disorders • Autism • Social interaction • Caregivers report that the child started to learn language but then stopped • Exhibit echolalia • Usual or peculiar differences • Person stores and produces the utterances but does not process the utterances internally • Hearing impairment • Severity of language impairment depends on the type and severity of the hearing loss • Evaluated by an audiologist • Appropriate hearing may be prescribed • Hearing aids apply hearing but they do not restore hearing • Cochlear implants give direct stimulation to the cochlear • Supplement their language with speech reading and manual signs

42. Language disorders • Language disorders in children • Specific language impairment • No cognitive, social, sensory, or motor problems • Demonstrate delays in language development • Lack of achieving linguistic milestones • Comprehend more than they produce • Difficulties extracting irregularities of language • Morphological disorders are evident • Vocabulary growth might also be a problem • Pragmatics may also be affected

43. Language disorders • Neglect and abuse • Lack of maternal interaction has a negative effect on language development • Pragmatics is a severe problem • They do not initiate and restrict their utterances in conversation • Traumatic brain injury • Effect on language varies with the site of lesion, degree and age of insult • Cognitive deficits such as attention, memory, perception, organization and problem solving are also affected • I million children and adolescents incur TBI • Language deficits include deficits in comprehension and difficulty with figurative language such as idioms, metaphors and proverbs • Problems with story grammar and sequencing parts of a narrative may also be affected

44. Language disorders • Language disorders in adults - Aphasias • Disruption of blood supply to the brain • Damage to neural tissue • Degenerative disease • Other problems co-exist with language impairments (poor judgment, sensory or motor impairments, memory problems) • Associated swallowing or motor speech disorder

45. Language disorders • Fluent or Wernicke's aphasia http://www.youtube.com/watch?v=aVhYN7NTIKU) • Non-fluent or Broca’s aphasia (http://www.youtube.com/watch?v=1aplTvEQ6ew)

46. Language disorders • Augmentative and alternative communication • If the person is not capable of developing functional speech, they may need to use an AAC system • Total communication approach • No tech (manual sign language) • Low tech (manual communication boards) • Mid tech (static display devices) • High tech (dynamic display devices) • Caregivers feel that use of AAC prevents further development of language but it only enhances language development • Strategies need to be taught on how to use the AAC systems