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Cognitive Communication Disorders 4th Edition Michael L
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Library of Congress Cataloging-in-Publication Data
Names: Robb, Michael P., author.
Title: INTRO: a guide to communication sciences and disorders / Michael P Robb
Other titles: Guide to communication sciences and disorders
Description: Fourth edition. | San Diego, CA: Plural Publishing, Inc., [2025] | Includes bibliographical references and index.
Identi ers: LCCN 2023034413 (print) | LCCN 2023034414 (ebook) | ISBN 9781635504767 (paperback) | ISBN 1635504767 (paperback) | ISBN 9781635504385 (ebook)
Subjects: MESH: Communication Disorders | Hearing Disorders
LC record available at https://lccn.loc.gov/2023034413
LC ebook record available at https://lccn.loc.gov/2023034414
To Jenne
CONTENTS
Foreword to the First Edition by John H. Saxman, PhD
Preface
Reviewers of the Fourth Edition
SECTION 1
Background to Communication Sciences and
Disorders
1 Communication Disorders and the Professions
Objectives
Key Terms
Introduction
Terminology and De nitions
Models of Communication
The Professions
A Brief History of the Professions
Educational Preparation
Professional Work Settings
Professional Ethics
Cultural Considerations and Communication Disorders
Summary of Chapter
The Professions of Audiology and Speech-Language Pathology on the World Wide Web
Study Questions
References
2 Anatomy of Speech and Hearing
Objectives
Key Terms
Introduction
Speech Anatomy
The Process of Speech Production
Hearing Anatomy
The Process of Hearing
Historic Aspects of Anatomy and Physiology
Cultural Considerations in Anatomy and Physiology
Summary of Chapter
Anatomy and Physiology on the World Wide Web
Study Questions
References
SECTION 2
Developmental Communication Disorders
3 Child Language Disorders
Objectives
Key Terms
Introduction
Terminology and De nitions
Language Development
Historic Aspects of Child Language Disorders
Types of Child Language Disorders
Current Theories Regarding Child Language Development and Disorders
Assessment of Child Language Disorders
Treatment of Child Language Disorders
Cultural Considerations and Child Language Disorders
Assessment
Summary of Chapter
Child Language Disorders on the World Wide Web
Study Questions
References
4 Child Speech Sound Disorders
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Child Speech Sound Disorders
Types of Speech Sound Disorders
Current Theories Regarding Child Speech Sound Disorders
Assessment of Child Speech Sound Disorders
Treatment of Child Speech Sound Disorders
Cultural Considerations and Child Speech Sound Disorders
Summary of Chapter
Child Speech Sound Disorders on the World Wide Web
Study Questions
References
5 Fluency Disorders
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Fluency Disorders
Types of Fluency Disorders
Current Theories Regarding Stuttering
Assessment of Fluency Disorders
Treatment of Fluency Disorders
Cultural Considerations and Fluency Disorders
Summary of Chapter
Fluency Disorders on the World Wide Web
Study Questions
References
6 Cleft Lip and Palate
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Cleft Lip and Palate
Disorders of Cleft Lip and Palate
Current Theories of Cleft Lip and Palate
Assessment of Cleft Lip and Palate
Treatment of Cleft Lip and Palate
Cultural Considerations and Cleft Lip and Palate
Summary of Chapter
Cleft Lip and Palate on the World Wide Web
Study Questions
References
7 Autism Spectrum Disorder
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Autism Spectrum Disorder
Autism Spectrum Disorder and Communication
Current Theories Regarding Autism Spectrum Disorder
Assessment of Autism Spectrum Disorder
Treatment of Autism Spectrum Disorder
Cultural Considerations and Autism Spectrum Disorder
Summary of Chapter
Autism Spectrum Disorder on the World Wide Web
Study Questions
References
SECTION 3
Acquired and Genetic Communication Disorders
8 Voice Disorders
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Voice Disorders
Types of Voice Disorders
Current Theories of Voice Disorders
Assessment of Voice Disorders
Treatment of Voice Disorders
Cultural Considerations and Voice Disorders
Summary of Chapter
Voice Disorders on the World Wide Web
Study Questions
References
9 Neurogenic Language Disorders
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Neurogenic Language Disorders
Types of Neurogenic Language Disorders
Current Theories Regarding Neurogenic Language Disorders
Assessment of Neurogenic Language Disorders
Treatment of Neurogenic Language Disorders
Cultural Considerations and Neurogenic Language Disorders
Summary of Chapter
Neurogenic Language Disorders on the World Wide Web
Study Questions
References
10 Motor Speech Disorders
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Motor Speech Disorders
Types of Motor Speech Disorders
Current Theories Regarding Motor Speech Disorders
Assessment of Motor Speech Disorders
Treatment of Motor Speech Disorders
Cultural Considerations and Motor Speech Disorders
Summary of Chapter
Motor Speech Disorders on the World Wide Web
Study Questions
References
11 Dysphagia
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Dysphagia
Types of Dysphagia
Causes of Dysphagia
Assessment of Dysphagia
Treatment of Dysphagia
Cultural Considerations and Dysphagia
Summary of Chapter
Dysphagia on the World Wide Web
Study Questions
References
12 Augmentative and Alternative
Communication
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Augmentative and Alternative Communication
Types of Augmentative and Alternative Communication
Assessment of Augmentative and Alternative Communication
Treatment of Augmentative and Alternative Communication
Cultural Considerations and Augmentative and Alternative Communication
Summary of Chapter
Augmentative and Alternative Communication on the World Wide Web
Study Questions
References
13 Genetics and Syndromes
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Genetics
Types of Syndromes
Assessment of Genetic Conditions
Treatment of Genetic Conditions
Cultural Considerations and Genetics
Summary of Chapter
Genetics and Syndromes on the World Wide Web
Study Questions
References
SECTION 4
Audition
14 Hearing Disorders
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Hearing Disorders
Types of Hearing Disorders
Assessment of Hearing Disorders
Online Hearing Measurement
Cultural Considerations and Hearing Disorders
Summary of Chapter
Hearing Disorders on the World Wide Web
Study Questions
References
15 Auditory Rehabilitation
Objectives
Key Terms
Introduction
Terminology and De nitions
Historic Aspects of Aural Rehabilitation
Treatment Approaches: Hearing Rehabilitation
Treatment Approaches: Speech and Language Rehabilitation
Cultural Considerations and Aural Rehabilitation
Summary of Chapter
Aural Rehabilitation on the World Wide Web
Study Questions References
Glossary Index
FOREWORD TO THE FIRST EDITION
Prior to his passing, Professor John H. Saxman (1938–2023) was intending to pen the Foreword to the fourth edition of INTRO. In memory of his contributions to the profession and support of this book, his original Foreword to the rst edition is provided below.
Welcome to the fascinating and complex elds of speech and language pathology and audiology. These two professions are applied elds that draw on theory and knowledge from a variety of disciplines that support the practices devoted to prevention, assessment and evaluation, and treatment of disorders of speech, language, and hearing across the life span of human beings. This textbook provides the beginning student with an understanding of the basic conceptual and content knowledge and the vocabulary necessary to appreciate the complexity of human communication disorders. Within the crowded arena of introductory textbooks, there are a number of features of this text that make it particularly appealing, not the least of which is the sole authorship by Professor Robb. The distinct advantage of one author is that the perspective across the various topics is consistent and presented in a cohesive organization and level throughout. Capturing the right level is important for an introductory text, and Professor Robb has done so based on his years of teaching the course for which this text is intended.
There are additional features of this text that add to its appeal. These features are in its contextualization. I applaud the approach the author takes to provide a context for both speech-language pathology and audiology within the broadly de ned communication sciences. The scope of practice within each profession engages activities not directly targeted at communication, such as swallowing or intraoperative auditory assessment; however, the raison d’être of these professions is situated in human communication. The inclusion of historical referents within each chapter is another appealing feature, which gives the beginning student a perspective on how the contemporary elds have evolved from the contributions of earlier scholars working in different disciplines such as physics, engineering, phonetics, psychology, medicine, and philosophy. The historical references also allow the student to appreciate the tremendous advances in technology that assist the current speech and hearing scientists and practitioners to better understand and serve individuals with communication impairments. Finally, the text is written with full recognition that students around the world are preparing for careers in speech and language pathology and in audiology. Although the education and training will follow different models and the practice requirements might be different in various countries, the core substance of the elds is essentially the same. The text limits its discussion to the English-speaking communities but clearly addresses the relevant multilingual/multicultural issues. Here the author brings his personal experience from teaching the introductory course in the United States and New Zealand.
A few observations about the communication context are in order. The overview of communication helps the reader appreciate the fundamental role of communication in all of nature. The most common de nitions of communication involve some description of a mutual exchange of information or energy between two entities with varying degrees of elaboration of the process and its outcomes. A de nition of this sort reminds us that communication is a universal among living entities ranging from the biochemical exchanges of
unicellular organisms to complex symbolic systems such as language in humans.
The simple three-component model of communication (a sender, a communication channel, and a receiver) adapted from Shannon and Weaver has the advantage of identifying the major functional components involved in the act of communication. The model is an abstraction of the factors that in uence and de ne the communication outcome. Applying this model to human communication and its disorders requires the speci c knowledge of how the communication partners, who are both senders and receivers, acquire and use natural language abilities and what factors can impair the ability to acquire and use language for effective communication. That, of course, leads beyond the abstraction of a communication model to the primary content of this textbook. The content is an elaboration on the speci cs of the human language user in a social milieu and the disorders that disrupt communication through problems that can originate anywhere within the communication dynamic. The human communicator is more than a “source code” generator and interpreter in an information system process and therein lies the nexus of communication sciences and disorders as a discipline of study.
Communicating with others is such a common experience that we give little thought to how it is accomplished. Because we are so familiar with being communicators, we generally are unaware of the learning and practice that went into developing the necessary communication skills that began as early as while still in the womb. We easily use different modes of communication available to us in our daily activities and only on occasion or in very limited circumstances do we experience the challenges of impeded communication. The situation is quite different, of course, for the person who has a communication disorder. The nature of the communication disorder and its consequences for the individual who experiences it depend on a host of interacting factors: organismic and environmental, developmental and acquired. The learning objectives stated for each chapter in this text appropriately
focus on understanding the nature and consequences of the major disorders and their treatment in human beings.
Finally, it is appropriate to recognize the importance of the author ’ s experience in the education of students at all levels of their apprenticeship in the eld. Because he has taught beginning students in a career spanning several decades, he is familiar with the changing learning culture and mode of today’s student. This experience is realized in the writing style and learning aids used throughout the text. In addition to his signi cant contributions as a teacher, Professor Robb has maintained an active research and scholarship agenda that gives him further credibility as an authoritative escort for beginning students in their introduction to the eld. On a personal note, it is a unique pleasure for me as I approach the close of my academic career to acknowledge a treasured friend and former student for his achievement in producing a book that promises to stimulate the development of many future careers in communication science and disorders.
John H. Saxman, PhD Professor Emeritus
Speech-Language Pathology and Audiology
Teachers College, Columbia University New York, New York
PREFACE
Since the original 2010 publication of INTRO: A Guide to Communication Sciences and Disorder, the book remains unique in many ways from other introductory texts. The structure of the book is consistent across chapters to assist beginning students in grasping new vocabulary and concepts. Each chapter provides a focus on “past and present.” An introduction to each of the various disorders would not be complete without knowing some of the fascinating historical background surrounding each disorder, as well as current theories. A portion of each chapter is dedicated to diverse and cultural aspects of communication disorders as well as prevalence information about various communication disorders as found in English-speaking countries around the world, including Australia, Canada, the United Kingdom, the United States, and New Zealand. The chapters include a series of FYI (for your information) items, which present interesting and novel information about the topic area. Websites are listed at the end of the chapters to provide students with an opportunity to learn more about each topic. Many of these websites provide up-to-date links to streaming video examples.
This fourth edition of INTRO has been expanded from 13 to 15 chapters. The original chapter covering neurogenic communication disorders has been divided into separate chapters on neurogenic language disorders and motor speech disorders. A new chapter on the ever-expanding topic of autism spectrum disorder is new to this
edition and provides more comprehensive coverage of the range of developmental communication disorders.
Being the sole author of this book ensures a balanced writing style that is missing from existing introductory texts. My intent is to deliver clear and concise information for students wishing to learn the fundamentals of the myriad of communication disorders that occur across the life span. For some, this information will serve as a springboard for pursuit of a professional career in audiology and speech-language pathology. For others, my hope is that you will acquire an appreciation of the gift of communication that we so often take for granted. Students and instructors alike should be pleased with this new edition of INTRO.
As in previous editions of the book, there are some individuals I wish to thank. I am particularly indebted to Ray Kent who encouraged me to write a book of this kind and provided valuable oversight throughout its creation. Most of the illustrations throughout the book were made possible by the tireless work of Chia Pan. My initial exposure to the eld of communication sciences and disorders was provided by my mother, Mary Jo Robb, whose professional career was spent educating children. During my rst year of university study, she introduced me to one of her colleagues, a school-based speech-language pathologist. After our meeting, I changed my university major to communication sciences and disorders and never looked back. Finally, there was no one more in uential in shaping my career than John Saxman (1938–2023), who passed away during the nal stages of this book revision. He was a soft-spoken, kind-hearted individual who was a superb mentor, good friend, and best man. Thank you, John.
— M. Robb
REVIEWERS OF THE FOURTH EDITION
Plural Publishing, Inc. and the author would like to thank the following reviewers for taking the time to provide their valuable feedback during the development process:
Jane Bickford, BAppSc (SpPath), PhD, CPSP
Lecturer
Speech Pathology and Audiology
Flinders University
South Australia, Australia
Angela D. Haendel, PhD Candidate, CCC-SLP
Clinic Director and Assistant Professor
Speech-Language Pathology
Concordia University Wisconsin
Mequon, Wisconsin
Melissa Johnson, PhD, CCC-SLP
Assistant Professor
Communication Sciences and Disorders
Nazareth College
Rochester, New York
Breanna Krueger, PhD, CCC-SLP
Assistant Professor
Communication Disorders
University of Wyoming
Laramie, Wyoming
Lisa Rickard, AuD, CCC-A
Assistant Clinical Professor
Department of Hearing and Speech Sciences
University of Maryland
College Park, Maryland
Carmen Larimore Russell, PhD, CCC-SLP
Professor and Chairperson
Communication Disorders and Deaf Education
Fontbonne University
Saint Louis, Missouri
Mohammed Sa , PhD, CCC-SLP
Assistant Professor
College of Applied Medical Sciences
King Saud University
Riyadh, Saudi Arabia
COMMUNICATION DISORDERS AND THE PROFESSIONS
OBJECTIVES
After reading this chapter, the student should be able to:
Recognize the different forms and types of communication.
Demonstrate an understanding of the audiology and speech-language pathology professions.
Describe the various work settings for audiologists and speech-language pathologists.
Demonstrate an understanding of developmental and acquired communication disorders.
Demonstrate an understanding of organic and functional communication disorders.
Demonstrate an understanding of epidemiology, including prevalence and incidence.
Demonstrate an understanding of the code of ethics.
Describe cultural competency in audiology and speechlanguage pathology.
KEY TERMS
Communication Disorder
Encode
Decode
Verbal Communication
Discussion
Dialogue
Debate
Nonverbal Communication
Paralanguage
Sign Language
Body Language
Tactile Communication
Proxemics
Physical Appearance
Model
Transmission Model
Feedback Loops
Speech Chain
Spoonerism
Developmental or Congenital Disorder
Acquired Disorder
Etiology
Organic Disorder
Functional Disorder
Idiopathic
Epidemiology
Prevalence
Incidence
Speech-Language Pathology
Audiology
Speech-Language Pathologist
Audiologist
John Thelwall
Alexander Melville Bell
Alexander Graham Bell
Visible Speech
Henry Sweet
Hermann Gutzmann
Logopedics
Wilhelm Wundt
Edward Wheeler Scripture
Carl Seashore
Samuel Orton
Lee Edward Travis
Charles Van Riper
Max Steer
Sara Stinch eld Hawk
Raymond Carhart
Hallie Quinn Brown
Itinerant Speech-Language Pathologist
Acute Care Hospital
Rehabilitation Hospital
Telehealth
Ethical Behavior
Code of Ethics
Bene cence
Nonmale cence
Evidence-Based Practice
Culturally Competent
Culturally Responsive
INTRODUCTION
Communication is any act involving the exchange of information related to a person’s needs, wants, perceptions, knowledge, or feelings. At birth we are equipped with the physical attributes to communicate. Our earliest forms of communication are quite basic and revolve around fundamental needs and desires between infant and caregiver. As we grow, we learn to communicate more effectively by observing other people communicating. We model our communication on what we see, hear, and experience. Our communication skills grow in complexity and sophistication through formal education, and by practicing those skills and having them evaluated.
Most of us take communication for granted. We tacitly assume that when we speak, we will be understood, or when someone speaks to us, we will understand them. Only when a breakdown in communication occurs do we realize how special and vital this act is to our daily lives. A communication disorder is a diagnosed condition in which a person is unable to say correctly what they want to say and/or is unable to understand some or most of what is being said. Some individuals may have an isolated impairment in speech or hearing; others may have impairment in both domains. Simply put, a communication disorder is any impairment in the exchange of information that deviates from what might be considered normal. The nature of the disorder may range from mild to severe. However, the impact of the disorder upon a person ’ s ability to communicate may be profound, regardless of the severity. The focus of this book concerns situations when the process of speaking and listening is somehow impaired. A communication disorder is one of the most common types of disabilities found throughout the world. When communication fails, misunderstandings occur, and sometimes people become frustrated, worried, or even angry. Some communication impairments are minor and can be easily corrected, whereas others are more severe
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