Speech Science An Integrated Approach to Theory and Clinical Practice, 3E Carole T. Ferrand Instruct

Instructor’s Manual and Test Bank for

Ferrand

Speech Science An Integrated Approach to Theory and Clinical Practice Third Edition prepared by

Monika Dziemianczuk

TABLE OF CONTENTS PREFACE

v

CHAPTER ONE: THE NATURE OF SOUND Chapter Overview Key Concepts Emphases & Instructional Activities Test Bank

1 2 4 5

CHAPTER TWO: RESONANCE Chapter Overview Key Concepts Emphases & Instructional Activities Test Bank

8 8 9 10

CHAPTER THREE: THE ARTICULATORY SYSTEM Chapter Overview Key Concepts Emphases & Instructional Activities Test Bank

13 14 17 18

CHAPTER FOUR: CLINICAL APPLICATION: EVALUATION AND TREATMENT OF DISORDERS REALTED TO ARTICULATION Chapter Overview 21 Key Concepts 22 Emphases & Instructional Activities 23 Test Bank 23 CHAPTER FIVE: THE PHONATORY SYSTEM Chapter Overview Key Concepts Emphases & Instructional Activities Test Bank

27 28 30 31

CHAPTER SIX: CLINICAL APPLICATION: EVALUATION AND TREATMENT OF PHONATORY DISORDERS Chapter Overview 34 Key Concepts 35 Emphases & Instructional Activities 36 Test Bank 37 CHAPTER SEVEN: THE RESPIRATORY SYSTEM Chapter Overview Key Concepts Emphases & Instructional Activities Test Bank iii

40 41 43 44

CHAPTER EIGHT: CLINICAL APPLICATION: EVALUATION AND TREATMENT OF RESPIRATORY DISODERS Chapter Overview 47 Key Concepts 47 Emphases & Instructional Activities 48 Test Bank 49 CHAPTER NINE: THE AUDITORY SYSTEM Chapter Overview Key Concepts Emphases & Instructional Activities Test Bank

52 53 55 55

CHAPTER TEN: CLINICAL APPLICATION: EVALUATION AND TREATMENT OF DISORDERS RELATED TO HEARING IMPAIRMENT Chapter Overview 59 Key Concepts 59 Emphases & Instructional Activities 60 Test Bank 61 CHAPTER ELEVEN: THE NERVOUS SYSTEM Chapter Overview Key Concepts Emphases & Instructional Activities Test Bank

64 66 70 71

CHAPTER TWELVE: CLINICAL APPLICATION: BRAIN IMAGING IN THE EVALUATION AND TREATMENT OF DISORDERS OF THE NERVOUS SYSTEM Chapter Overview 64 Key Concepts 66 Emphases & Instructional Activities 70 Test Bank 71 CHAPTER THIRTEEN: MODELS AND THEORIES OF SPEECH PRODUCTION AND PERCPETION Chapter Overview 82 Key Concepts 82 Emphases & Instructional Activities 83 Test Bank 84 THE SPEECH SCIENCE THIRD EDITION TEST BANK ANSWER KEY Chapter 1 – Chapter 3 Chapter 4 – Chapter 6 Chapter 7 – Chapter 9 Chapter 10 – Chapter 11 Chapter 12 – Chapter 13

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87 88 89 90 91

PREFACE This instructor’s manual and test bank is designed to accompany the third edition of Speech Science: An Integrated Approach to Theory and Clinical Practice. The purpose of this manual is to provide instructional and testing material to support classroom lectures. Suggestions for teaching methods are offered, but may be adjusted according to each instructor’s preference of style and key emphases.

Each chapter provides the following: (1) a chapter overview; (2) key concepts; (3) a list of emphases; (4) suggested discussion topics and instructional activities; (5) test bank. The test bank includes multiple choice questions, true-false questions, short answer questions, and essay questions. The answer key for multiple choice and true-false questions is provided at the end of the manual.

CHAPTER OVERVIEW AND SUMMARY The chapter overview and narrative summary provide a guideline that the instructor can use to construct class lectures, or to determine which information he or she would like to focus on.

Information presented in these sections may also be provided to students in order to familiarize them with material that will be introduced, and give them a foundation for the upcoming concepts.

KEY CONCEPTS The key concepts focus attention on important material covered in each chapter. These pages may be photo-copied and distributed to students. Instructors may provide the key concepts at the beginning of a chapter, prompting students to complete the definitions. This allows students to become familiar with the information and helps to develop a framework to follow the instructor’s presentation of the material. Instructors may also choose to provide the concepts before an exam, as a means of reviewing information. Additionally, key concepts may be used as pre- and post-tests to assess student knowledge.

EMPHASES AND INSTRUCTIONAL ACTIVITIES This section offers suggestions for topics to be introduced and discussed by the instructor. Some ideas for manner of presentation are included, such as using graphs, charts, or diagrams to acquaint students with more complex information. Within each section there are various discussion topics and instructional activities that may be used to demonstrate more elusive concepts and further support classroom lectures.

TEST BANK A series of test questions are presented at the conclusion of each chapter. Instructors may select specific questions as a supplement to their own prepared examination, distribute the test bank in its entirety, or use the test bank as a general review before administering their own examination.

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CHAPTER ONE THE NATURE OF SOUND CHAPTER OVERVIEW I. THE NATURE OF SOUND • Defining Science and Its Relationship to Human Speech • International System of Units II. BASIC PHYSICS CONCEPTS • Mass, Force, Weight, Volume and Density • Speed, Velocity, Momentum, Acceleration and Inertia • Elasticity and Stiffness • Work, Energy, Power and Intensity • Pressure III. OVERVIEW OF SOUND • Air Pressure • Airflow • Air Pressure, Volume and Density • Changes in Air Pressure • Elasticity, Inertia and Friction • Wave Motion of Sound • Mass/Spring System • Simple Harmonic Motion • Frequency, Period, Wavelength, Velocity and Amplitude IV. PURE TONES • Waveforms V. COMPLEX SOUNDS • Line Spectra VI. SOUND ABSORPTION, REFLECTION, REFRACTION AND DIFFRACTION VII. CONSTRUCTIVE AND DESTRUCTIVE INTERFERENCE VIII. ATTRIBUTES OF SOUNDS • Frequency and Pitch • Human Range of Hearing • Amplitude, Intensity and Loudness • Decibel Scale • Advantages of the Decibel Scale 1

•

Application of the dB Scale

KEY CONCEPTS ABSORPTION AIR AIR FLOW AIR PRESSURE AMBIENT PRESSURE AMPLITUDE AUDIOGRAMS BOYLE’S LAW CHANGES IN PRESSURE COMPLEX TONES COMPRESSION CONSTRUCTIVE INTEREFERENCE DAMPING DECIBEL SCALE DESTRUCTIVE INTEREFERENCE DIFFRACTION DRIVING PRESSURE ELASTICITY FREQUENCY FUNDAMENTAL FREQUENCY HERTZ

2

INCIDENT WAVE INTENSITY LAMINAR FLOW LINEAR SCALE LOGARITHMIC SCALE PERIOD PERIODIC PITCH PURE TONE RATIO SCALE RAREFACTION REFLECTION REFRACTION SIMPLE HARMONIC MOTION SPECTRA THRESHOLD OF HEARING THRESHOLD OF PAIN TURBULENT FLOW VELOCITY WAVEFORMS WAVELENGTH

3

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Review basic terms and concepts, such as mass, density, volume, pressure, etc.

2. Explain the relationship between air pressure and sound.

3. Students will understand the power of air pressure as well as changes in pressure with this simple demonstration. Use a peeled hard-boiled egg, a jar with an opening that is slightly smaller than the diameter of the egg, a piece of paper and a lighter. Light the piece of paper and drop it into the bottle. Place the hard-boiled egg on the opening of the bottle. Increasing the temperature of air inside the bottle increases the pressure. Once the flame goes out, the pressure inside the bottle decreases relative to atmospheric pressure, and the positive atmospheric pressure pushes the egg into the bottle.

4. Describe simple harmonic motion (SHM), frequency, period, wavelength, velocity and amplitude.

5. Simple harmonic motion, frequency, and amplitude can be shown by using strings of different lengths with hex nuts attached to one end of each string. When swung the string acts like a pendulum, and makes it easy for students to visualize the smooth back and forth motion that is characteristic of SHM, as well as the relationship between frequency and amplitude.

6. You can also demonstrate simple harmonic motion by using a hanging spring with a mass attached to the end. As you pull the mass down and release it, the spring will continue to move up and down in a repetitive motion. This will continue until the motion gradually fades away. On page 16 of the text, an illustration demonstrates what would occur if a marker was attached to the spring as it moves up and down.

7. Frequency, amplitude, and constructive/destructive interference can be demonstrated using a long slinky. Have two students stand across from one another with a slinky placed on a table between them. One student gives the slinky a push, generating a wave that travels along the length of the slinky. Pushing the slinky more forcefully increases the amplitude; pushing it more quickly increases the frequency. When the students push the slinky at either end, waves are generated from each end and travel toward each other. These waves will interfere either constructively, increasing the amplitude, or destructively, decreasing the amplitude.

8. Introduce pure tones versus complex sounds and waveforms versus spectra. Discuss the types of information that can be obtained from each type of graph. Prepare a variety of waveforms and spectra of pure tones and complex periodic and aperiodic sounds and have students interpret the graphs in terms of their perceptual and acoustic characteristics.

9. Describe the decibel scale and its relevance to an audiogram.

4

10. Many apps are available that analyze frequency and amplitude. Students can download these onto their smartphones or tablets and they provide a fun and easy way of becoming familiar with these concepts.

CHAPTER ONE TEST BANK MULTIPLE CHOICE QUESTIONS 1. An object’s resistance to changing its state of motion or rest is known as a. Inertia b. Momentum c. Newton’s Second Law of Motion d. Acceleration 2. Compression occurs when a. Air molecules collide, creating an area of positive pressure. b. Air molecules return to their equilibrium position. c. Air molecules collide, creating an area of negative pressure. d. Air molecules overshoot their equilibrium position.

3. If the tympanic membrane (TM) is in the path of shifting molecules, then a. Compression moves the TM inward b. Rarefaction moves the TM outward c. A & B d. None of the above 4. The three forces that interact to keep molecules swinging back and forth around their equilibrium positions before they settle down again are a. Elasticity, friction and propagation b. Friction, damping, and simple harmonic motion c. Driving pressure, elasticity, and inertia d. Elasticity, inertia and friction 5. Which law states that a volume varies inversely with pressure, given a constant temperature? a. Boyle’s Law b. Hooke’s Law c. Newton’s Second Law of Motion d. None of the above 6. All of the following influence the frequency of a vibrating object EXCEPT a. Length b. Pitch c. Density d. Tension

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7. The frequency range that that humans tend to hear best is a. 1 kHz to 4 kHz b. 500 Hz to 8 kHz c. 0 to 140 dB d. 10 to 130 dB 8. Sound occurs when a disturbance creates alternating increases and decreases in a. Oral pressure b. Tympanic membrane pressure c. Ambient pressure d. Tracheal pressure 9. What is the frequency and period of a tuning fork vibrating at 500 cycles per second? a. F = 500Hz, t = 0.004s b. F = 250 Hz, t = 0.004s c. F = 250 Hz, t = 0.002s d. F = 500 Hz, t = 0.002s 10. During Brownian motion, a. Molecules move around in systematic pathways. b. Molecules move around at extremely high speeds and in random patterns. c. A&B d. None of the above TRUE AND FALSE QUESTIONS 1. Waveforms are graphs with time on the horizontal axis and amplitude on the vertical axis.

A) TRUE

B) FALSE

2. Pure tones have more than one frequency and are graphed as sinusoidal waves.

A) TRUE

B) FALSE

3. Frequency is the subjective perception of how high or low a sound is on a musical scale.

A) TRUE

B) FALSE

4. The decibel scale is a linear scale that compares any target sound with a standard reference sound.

A) TRUE

B) FALSE

5. The human auditory system responds more favorably to sounds in the midrange of frequencies than those that are very high or very low.

A) TRUE

B) FALSE 6

6. An auditory area graph is used to represent an individual’s hearing by measuring his or her threshold at selected frequency levels.

A) TRUE

B) FALSE

7. Vibration of a source in simple harmonic motion results in a pure tone with only one frequency.

A) TRUE

B) FALSE

8. Increasing the density of a vibrating object will decrease its rate of vibration.

A) TRUE

B) FALSE

9. A complex periodic wave has a musical tone and a specific pitch.

A) TRUE

B) FALSE

10. Constructive interference occurs when two areas of low pressure combine, resulting in a decrease in amplitude.

A) TRUE

B) FALSE SHORT ANSWER QUESTIONS

1. Explain the terms absorption, reflection, and diffraction.

2. Define Hooke’s Law and explain its relationship to the vibration of a tuning fork.

3. Explain the relationship between the predictable movement of air molecules and driving pressure.

4. Describe how the decibel scale is a logarithmic ratio scale and provide an example of how the scale works.

5. Define the following concepts and label each concept as a subjective or objective phenomenon: frequency, pitch, amplitude, intensity, loudness.

ESSAY QUESTIONS 1. Air flow may be turbulent or laminar. Define these two terms and relate each type of air flow to speech production. Provide examples of phonemes that are produced with relatively laminar or relatively turbulent flow.

2. Discuss the movement of molecules when a tuning fork is struck. Include the terms compression, rarefaction, elasticity, inertia and friction in your discussion.

3. Explain constructive and destructive interference. Use diagrams to illustrate your answer.

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4. Compare and contrast pure tones and complex sounds.

5. Compare and contrast waveforms and spectra. Be sure to include the type of information that each provides. Use diagrams to illustrate your response.

CHAPTER TWO RESONANCE CHAPTER OVERVIEW I. RESONANCE II. ACOUSTIC RESONANCE • Tube Resonance and Standing Waves • Acoustic Resonators as Filters • Bandwidth • Cutoff Frequencies • Resonance Curves • Parameters of a Filter • Types of Filters III. VOCAL TRACT RESONANCE • Characteristics of the Vocal Tract Resonator • Source-Filter Theory of Vowel Production • Formant Frequencies Related to Oral and Pharyngeal Volumes • Vowel Formant Frequencies • F1/F2 Plots KEY CONCEPTS ACOUSTIC RESONANCE APPLIED FREQUENCY BANDWIDTH BROADLY TUNED CUTOFF FREQUENCY FORMANTS 8

F1/F2 PLOTS HALF-WAVE RESONATOR NATURAL FREQUENCY QUARTER-WAVE RESONATOR RESONANCE CURVE RESONANT FREQUENCY SHARPLY TUNED SOURCE-FILTER THEORY VOWEL FORMANT FREQUENCIES

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Introduce the difference between free and forced vibration. Explain that forced vibration is the basis of resonance. You can easily demonstrate forced vibration by placing a radio on a light table.

Turn up the volume to a moderate level and have students feel the table. Increase the volume while the students continue to feel the table. Have the students think about the table’s vibration in terms of natural frequency, free vibration, forced vibration and driving frequency.

2. Discuss acoustic resonance and tube resonance.

3. Explain the filtering properties of acoustic resonators. You can use the common experience of holding a seashell to the ear and hearing “the sound of the sea” as an example of acoustic resonance.

There is always background noise present even in a very quiet room. This noise is composed of low intensity sound waves with a broad range of frequencies. The background noise creates vibrations within the shell. As with any air-filled container, the seashell has a natural frequency or frequencies at which it will vibrate with greatest amplitude. Some of the frequencies in the room (applied frequencies) are likely to be close to the natural frequencies of the shell, creating constructive interference and causing those frequencies to become audible when the shell is held close to the ear.

4. Review resonance curves, bandwidth, center frequency, cutoff frequency and different types of filters. Have students draw resonance curves of broadly tuned and sharply tuned resonators.

5. Introduce vocal tract resonance, listing the characteristics of the vocal tract in its role as an acoustic resonator.

6. Describe the source-filter theory. Relate the theory to formants and the formant frequencies that are influenced by oral and pharyngeal cavity volumes.

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7. Explain vowel formant frequencies and how manipulation of vocal tract length, location of constriction and degree of constriction influence the resonant frequencies of the vocal tract.

8. Discuss F1/F2 plots, noting the relationship between the articulation of the corner vowels and their acoustic correlates. Prepare a handout of several examples of F1/F2 plots and have students interpret them. Discuss how these graphs may be used clinically to show differences in vowel articulation before and after treatment.

9. Download the free acoustic analysis program, Praat (www.praat.org). Ask students to record different vowels and compare the vowel formants. Point out the inter-individual differences between students’ productions of the same vowel, and discuss the reasons for these differences.

CHAPTER TWO TEST BANK MULTIPLE CHOICE QUESTIONS 1. All of the following elements are considered in the source-filter theory of vowel production EXCEPT a. Glottal sound b. Vocal tract resonator c. Sound at the lips d. Cutoff frequencies 2. The range of frequencies that a resonator will respond to is known as its a. Center frequency b. Attenuation rate c. Bandwidth d. Band-stop filter 3. Which of the following is true of quarter-wave resonators? a. The lowest RF has a wavelength that is four times the length of the tube. b. The higher RFs are odd number multiples of the lowest RF. c. The vocal tract is an example of a quarter-wave resonator. d. All of the above.

4. A resonance curve a. Describes the way a resonator vibrates in response to an applied frequency. b. Is a graph that represents the glottal spectrum. c. Is the point at which a resonant system becomes unresponsive. d. None of the above.

5. Which of the following statements best describes resonant frequency? a. It is the frequency that acts as an input to a resonator. b. Occurs when vibrations of one object set another object into vibration.

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c. Frequency at which a resonator undergoes the greatest vibratory response. d. Occurs when an object is a specific length, density and stiffness.

6. An acoustic resonator acts as a filter a. By attenuating frequencies farther away from its own RF. b. By amplifying frequencies close to its own RF. c. Because it is filled with air. d. All of the above.

7. An irregularly shaped acoustic resonator will be a. Narrowly tuned and lightly damped. b. Broadly tuned and heavily damped. c. Narrowly tuned and heavily damped. d. Broadly tuned and lightly damped.

8. The resonant frequency of a tube is related to a. The length of tube b. The tube’s geometry c. Whether it has closed or open ends d. All of the above.

9. The 3 dB down point is a. The upper and lower cutoff frequency of a resonator b. Where the greatest amplitude of vibration occurs c. The frequency that the resonator best responds to d. An attenuation rate of a filter 10. The F1 on an F1/F2 plot represents a. Tongue advancement b. Tongue height c. Tongue shape d. Lip position TRUE AND FALSE QUESTIONS 1. The source-filter theory is based on a male’s vocal tract positioned for the schwa vowel.

A) TRUE

B) FALSE

2. Air-filled cavities with a larger volume will respond best to lower driving frequencies.

A) TRUE

B) FALSE

3. Vowel formants are unaffected by the speaker’s age and gender.

A) TRUE

B) FALSE

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4. Resonant systems always have a clear-cut point above which frequencies are amplified and below which they are attenuated.

A) TRUE

B) FALSE

5. Forced vibration is the basis of resonance.

A) TRUE

B) FALSE

6. When an object is set into vibration and allowed to continue without interference, it will always vibrate at its natural frequency.

A) TRUE

B) FALSE

7. Frequencies within a resonator’s bandwidth will generate an output that is at least 70.7% of the amplitude of the vibrations caused by the frequency closest to the resonant frequency.

A) TRUE

B) FALSE

8. A narrow tube with a bandwidth of 100 Hz would respond to frequencies within 100 Hz below or 100 Hz above its resonant frequency.

A) TRUE

B) FALSE

9. The vocal tract’s irregular shape makes it a broadly tuned resonator that transmits a wide range of frequencies.

A) TRUE

B) FALSE

10. According to the source-filter theory, the output function represents the glottal sound that has been filtered according to the frequency response of the vocal tract.

A) TRUE

B) FALSE SHORT ANSWER QUESTIONS

1. Explain how forced vibration forms the basis for resonance.

2. Explain the relationship between interference and acoustic resonance.

3. Define resonant frequency, and discuss the physical elements that influence the resonant frequency of an object.

4. Discuss the importance of the schwa vowel and its relevance to the source-filter theory.

5. Using the example seen in cartoons, explain why it is possible for a singer to reach a high note and shatter a nearby glass.

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ESSAY QUESTIONS 1. Explain what a resonance curve is, including a discussion of 3 dB down points, cutoff frequencies, and center frequency.

2. Compare and contrast broadly tuned and narrowly tuned resonant systems. Explain which system is more common in terms of hearing and speech anatomy, and why this type of system is beneficial.

3. Describe the source-filter theory of vowel production. Use the graph associated with each element of the theory to illustrate your response.

4. Discuss the formant frequency differences between the production of /i/ and /u/. Use F1/F2 plots to illustrate your response.

5. List and discuss the four characteristics of the vocal tract that make it a unique acoustic resonator.

CHAPTER THREE THE ARTICULATORY SYSTEM CHAPTER OVERVIEW I. ARTICULATORS OF THE VOCAL TRACT • Oral Cavity • Lips • Mandible • Teeth o Dental Occlusion • Hard Palate • Soft Palate o Muscles of the Velum o Velopharyngeal Closure • Tongue o Muscles of the Tongue o Tongue Movements for Speech and Swallowing II. PHARYNX • Muscles of the Pharynx • Nasal Cavities • Valves of the Vocal Tract III. TRADITIONAL CLASSIFICATION SYSTEM OF CONSONANTS AND VOWELS • Place of Articulation of English Consonants • Manner of Articulation of English Consonants 13

• •

o Stops o Fricatives o Affricates o Nasals o Liquids o Glides Voicing Vowel Classification

IV. ACOUSTIC CHARACTERISTICS OF VOWELS AND CONSONANTS • Spectrographic Analysis • Narrowband and Wideband Spectrograms • Vowels • Diphthongs • Nasals • Glides • Liquids • Stops • Fricatives • Affricates V. THE PRODUCTION OF SPEECH SOUNDS IN CONTEXT • Coarticulation • Suprasegmentals o Intonation o Stress o Duration KEY CONCEPTS AFFRICATES APONEUROSIS ASPIRATION BREATH GROUPS COARTICULATION COGNATES CORNER VOWELS CRICOPHARYNGEUS MUSCLE 14

DIPHTHONGS DISTOCLUSION DURATION FORMANT TRANSITIONS FRICATION FRICATIVES GLIDES HETERONYMS HYPERNASALITY HYPONASALITY INTERMAXILLARY SUTURE INTONATION LABIAL VALVE LARYNGEAL VALVE LARYNGOPHARYNX LEVATOR VELI PALATINI LINGUAL FRENULUM LINGUAL VALVE LIQUIDS MALOCCLUSION MANNER OF ARTICULATION MEDIAN SULCUS MESIOCLUSION MICROGNATHIA 15

MONOPHTHONGS MUSCULAR HYDROSTAT MUSCULUS UVULI NASAL CONCHAE NASALS NASAL SEPTUM NASOPHARYNX NEUTROCLUSION OBSTRUENT SOUNDS OCCLUSION OFFGLIDE ONGLIDE ORBICULARIS ORIS OROPHARYNX PALATINE PROCESSES PALATOGLOSSUS PALATOPHARYNGEUS PHARYNGEAL CONSTRICTORS PHARYNGOESOPHAGEAL SEGMENT PLACE OF ARTICULATION RELEASE BURST SIBILANTS SILENT GAP SONORANT SOUNDS 16

SPECTROGRAPHY STOPS STRESS STRIDENTS SUPRASEGMENTAL CHARACTERISTICS TENSOR VELI PALATINI VELOPHARYNGEAL PASSAGE VELOPHARYNGEAL VALVE VELUM VOICE ONSET TIME (VOT) VOICING VOWEL QUADRILATERAL VOWEL REDUCTION

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Review the articulators of the vocal tract and discuss their valving functions. Describe the role of each articulator in speech production, emphasizing the importance of the tongue for speech sounds.

2. Introduce the traditional classification system for consonants, including the three features of manner, place and voicing. After reviewing each feature, create blank charts, similar to those on pages 94, 95 and 101, and have the students complete them.

3. Describe the traditional classification system for vowels using the vowel quadrilateral and its relationship to tongue height and tongue advancement. Ask students to produce the front and back vowels from high to low, and to switch back and forth from front to back vowels. During this exercise they should be encouraged to focus on the movements of the tongue.

4. Explain spectrographic analysis and its usefulness in providing information about the acoustic characteristics of vowels and consonants. Ask students to describe the articulatory patterns of specific phonemes, and to explain the links between the articulation and the resulting acoustic characteristics of the phoneme. Then show illustrations or draw spectrograms of the phonemes to illustrate the relationship between the articulation and acoustic features.

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5. Using the spectrographic analysis program in Praat, generate spectrograms of different phonemes produced in isolation. Distribute the spectrograms to students, and ask them to identify the phoneme. Have the students describe specific features they used in the identification. A variant of this activity is to have students draw their own spectrogram of given phonemes. Students can then produce and spectrographically analyze phonemes using Praat, and compare the Praat spectrograms with their hand-drawn examples.

6. Discuss connected speech in terms of the roles of coarticulation and suprasegmentals. Highlight the influence of each factor on the production of sounds in terms of syllables, words and lengthier utterances. Show spectrograms of various syllables and words, pointing out the differences between sounds in isolation and in connected speech.

CHAPTER THREE TEST BANK MULTIPLE CHOICE QUESTIONS 1. The orbicularis oris a. Is a circular muscle that makes up the upper and lower lips. b. Is an isolated muscle that moves the upper lip. c. Is a small flap of tissue that connects the lower lip to the mandible. d. Is what gives the lips their characteristic red color.

2. When the first molar of the lower jaw is anterior to its normal position, this creates a. Neutrocclusion b. Distocclusion c. Mesiocclusion d. Inversion 3. The velum a. Can form a barrier between the oral and nasal cavities b. Is made of bone and soft tissue c. Is immovable d. A & B 4. Problems with velopharyngeal function can result in air escaping through the nasal cavities rather than through the oral cavity during the production of oral sounds. The resulting speech production is characterized by a. Hyponasality b. Hypernasality c. Insufficient nasal resonance d. Velopharyngeal closure 5. The intrinsic muscles of the tongue a. Attach the tongue to other structures outside of the oral cavity b. Move the tongue to different positions within the oral cavity c. Move the tongue as a unit 18

d. Adjust the fine movements of shape and position of the tongue 6. All of the following are extrinsic muscles of the tongue EXCEPT a. Genioglossus b. Styloglossus c. Palatoglossus d. Inferior longitudinal 7. Motorically speaking, which of the following sounds is the least complex to produce? a. /s/ b. /o/ c. /t/ d. /r/ 8. Sonorant sounds are a. Nasals, glides and liquids b. Made with a less constricted vocal tract c. Produced when the lips close completely d. A & B 9. Which of the following statements (if any) is NOT true of fricatives? a. They are formed when two articulators come close to each other but do not make contact. b. They are produced when turbulent airflow is forced under high pressure through a narrow channel. c. There are five voiceless and four voiced fricatives in English. d. All of the above statements are true.

10. On a spectrogram, the acoustic features of a silent gap, release burst, voice onset time and formant transitions occur in a. Stops b. Fricatives c. Liquids d. Diphthongs TRUE AND FALSE QUESTIONS 1. Affricates contain the acoustic characteristics of both stops and fricatives.

A) TRUE

B) FALSE

2. The phenomenon of preceding and following sounds overlapping and influencing one another is known as intonation.

A) TRUE

B) FALSE

3. Sibilants have more acoustic energy in the lower frequencies and are less intense than nonsibilants.

A) TRUE

B) FALSE 19

4. Fricatives are continuous sounds and appear as wide bands of acoustic energy, distributed over a broad range of frequencies on a spectrogram.

A) TRUE

B) FALSE

5. Voiceless stops are characterized by aspiration and their bursts are longer in duration than voiced stops.

A) TRUE

B) FALSE

6. The levator veli palatini makes up most of the velum and its primary function is to raise the velum.

A) TRUE B) FALSE 7. The four valves of the vocal tract are the labial valve, the lingual valve, the velopharyngeal valve and the esophageal valve.

A) TRUE

B) FALSE

8. The phoneme /t/ is an alveolar voiceless fricative.

A) TRUE B) FALSE 9. The traditional classification system of consonants has seven primary places of articulation and six manners of articulation in English.

A) TRUE

B) FALSE

10. Formant transitions are characteristic of nasals, liquids, and diphthongs.

A) TRUE

B) FALSE SHORT ANSWER QUESTIONS

1. Discuss the role of the lips in terms of speech production and mastication.

2. Describe specific ways in which weakness of the tongue might affect speech and swallowing.

3. Compare and contrast the acoustic features of vowels and diphthongs as seen on a spectrogram.

4. Discuss the structure and function of the soft palate, including the role of velopharyngeal closure in speech production.

5. List the four valves of the vocal tract. Include the anatomical structures that are associated with each valve and the importance each valve has in speech production.

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ESSAY QUESTIONS 1. Identify and discuss the three primary features of suprasegmentals. Explain how each of these plays a role in the expression and intelligibility of speech.

2. Discuss why coarticulation makes speech transmission rapid and efficient.

3. Compare and contrast the articulatory and acoustic features of stops and nasals. Draw spectrograms of a stop and a nasal to illustrate your response.

4. Discuss the dimensions of vowel classification. In your response, include a diagram of the vowel quadrilateral, descriptions of the vertical and horizontal planes, and classify the vowels according to their position on the quadrilateral.

5. Identify and describe the places and manners of articulation in English, providing an example of at least one phoneme for each.

CHAPTER FOUR EVALUATION AND TREATMENT OF DISORDERS RELATED TO ARTICULATION CHAPTER OVERVIEW I. KINEMATIC MEASURESMENT OF ARTICULATORY VARIABLES • Cineradiography • Strain Gauge • X-Ray Microbeam • Ultrasound • Electropalatography and Glossometry • Magnetic Resonance Imaging • Electromagnetic Articulography II. ARTICULATION AND INTELLIGIBILITY III. DYSARTHTRIA/APRAXIA • Acoustic Measures o Vowel Formant Analysis o Spectral Analysis of Consonants • Kinematic Measures o Cineradiography o Strain Gauge o Electropalatography o Electromagnetic Articulography IV. HEARING IMPAIRMENT

21

• • •

Acoustic Measures Kinematic Measures o Electropalatography and Glossometry Cochlear Implantation o Acoustic Measures o Kinematic Measures

V. PHONOLOGICAL/ARTICULATION DISORDERS • Acoustic Measures • Kinematic Measures o Ultrasound o Electropalatography VI. CLEFT PALATE KEY CONCEPTS APRAXIA CINERADIOGRAPHY CLEFT PALATE DYSARTHRIA ELECTROMAGNETIC ARTICULOGRAPHY ELECTROPALATOGRAPHY GLOSSOMETRY HEARING IMPAIRMENT KINEMATIC MEASUREMENT MAGNETIC RESONANCE IMAGING PHONOLOGY/ARTICULATION STRAIN GAUGE X-RAY MICROBEAM ULTRASOUND

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EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Introduce the concept of kinematic analysis. Review different types of kinematic measures and what type of information each provides in terms of speech production.

2. Explain the relationship between articulation and intelligibility, and describe the measures that can be used to assess intelligibility. Play recordings of individuals with and without intelligibility difficulties, and have students transcribe them.

3. Identify the kinematic and acoustic measures used for each disorder presented in the chapter.

Include audio and/or video clips to demonstrate the articulation impairments presented by individuals with these disorders.

4. Ask students to identify which types of acoustic and kinematic measures may be most useful in assessing each type of disorder, why they would choose that specific measure, and what type of information they might obtain from the assessment.

5. If possible, have the students record individuals with dysarthria, cleft palate, hearing impairment, or phonological disorders. Create a set of sentences to compare between the students and the individuals with disorders of speech production. Use Praat to create spectrograms of the recorded sentences and have the students compare and contrast the features seen in disordered speech and their own speech patterns.

CHAPTER FOUR TEST BANK MULTIPLE CHOICE QUESTIONS 1. One of the major disadvantages of electropalatography is a. It does not visualize high vowels. b. It does not provide real-time visual display. c. It does not visualize mid and low vowels. d. It does not provide instant feedback.

2. All of the following are safe, non-invasive procedures for observing articulatory movement EXCEPT a. Cineradiography b. Glossometry c. Electropalatography d. Electromagnetic articulography 3. The slope index provides diagnostic information regarding a. Articulation during conversation. b. Tongue height during speech. c. Spectral analysis of specific consonants. d. Range of tongue movement.

23

4. Slowing rate of speech is a popular therapeutic technique that may benefit individuals with a. Phonological impairments b. Dysarthria c. Cleft Palate d. A & B 5. Articulatory undershoot occurs when a. Articulators take a longer time than normal to reach their target b. Articulators take a shorter time than normal to reach their target c. Articulators do not reach their target before they begin the following sound d. Articulators reach their target with an exaggerated range of motion 6. Which of the following can affect a speaker’s intelligibility? a. Degree of precision of articulation b. Rate of speech c. Loudness, pitch, prosody d. All of the above can affect intelligibility.

7. Hearing impaired speakers may demonstrate a. Difficulty producing enough variation in F0 to differentiate between declarative versus interrogative utterances. b. Flat or changing contours at the end of words, rather than falling contours. c. Production of alveolar and velar stops with the constriction farther back than typical. d. All of the above.

8. Which of the following is true of phonological processes? a. They may be present in typically developing children. b. They affect children from birth to two years of age. c. They often result from hearing impairments. d. They cannot be treated using kinematic measures.

9. Why are stops, fricatives and affricates particularly difficult to produce for individuals with cleft palate? a. These phonemes require a high degree of neuromuscular control. b. These phonemes require a strong buildup of oral pressure. c. These phonemes require intricate and precise tongue movement. d. These phonemes require tongue-palate contact in order to be produced.

10. Glossometry is useful for a. Training hearing impaired speakers to produce consonants and vowels b. Displaying the position and shape of the tongue c. A & B d. None of the above.

24

TRUE AND FALSE QUESTIONS 1. Electropalatography shows tongue contact patterns in real time giving instantaneous feedback about the speaker’s articulatory positions.

A) TRUE

B) FALSE

2. MRI technology is useful for imaging the vocal tract and articulators during rapid connected speech.

A) TRUE

B) FALSE

3. Intelligibility is often measured perceptually, which provides detailed information about a speaker’s underlying articulatory patterns.

A) TRUE

B) FALSE

4. Individuals with dysarthria often exhibit difficulty with the timing of their articulatory movements.

A) TRUE

B) FALSE

5. Perceptual measurements are useful for revealing timing abnormalities in speakers with ALS and aid in early detection of this disease.

A) TRUE

B) FALSE

6. Speakers with dysarthria may demonstrate a reduced vowel space, in which values for corner vowels shift to a more neutralized position.

A) TRUE

B) FALSE

7. Showing spectrograms to a child producing a target sound has the advantage of providing instant visual feedback and is a beneficial therapeutic technique.

A) TRUE

B) FALSE

8. Speakers with cleft palate may demonstrate velopharyngeal problems that contribute to distortions of resonance as well as misarticulations.

A) TRUE

B) FALSE

9. Studies have shown that visual feedback devices (i.e., electropalatography) are useful and quick methods of aiding speakers with articulatory difficulties, but traditional speech therapy is required to facilitate generalization of the correct productions.

A) TRUE

B) FALSE

25

10. A higher than normal F2 frequency indicates that the tongue is not achieving the appropriate amount of tongue height for that phoneme.

A) TRUE

B) FALSE SHORT ANSWER QUESTIONS

1. Identify and describe the following terms: phonological processes, intelligibility, scaling procedures, identification tasks.

2. Describe the acoustic characteristics of dysarthric speech and relate them to the underlying articulatory problems.

3. Why is it important to understand the underlying articulatory patterns of an individual with articulation impairment? Describe the acoustic and kinematic information that should be obtained in order to provide the most effective treatment for the individual 4. Use the information presented in the chapter as well as information from other sources to argue whether segmental or suprasegmental features of speech should be addressed first when treating a hearing impaired individual 5. Describe the difficulties with articulation that a speaker with cleft palate may experience. Include examples of specific phonemes and treatment strategies in your response.

ESSAY QUESTIONS 1. Compare and contrast acoustic and kinematic measurements used to evaluate and treat disorders of articulation/phonology. Include the possible advantages and disadvantages of each measure.

2. Define the term “productive knowledge”. Explain the steps of acoustic analysis that are taken to determine whether a child has productive knowledge of a particular phoneme.

3. Explain the usefulness of vowel formants in gathering information about articulatory patterns of typical speakers and those with articulatory disorders. How can such data be useful in determining the most effective type of treatment?

4. Which type of kinematic measure would be most beneficial when assessing a child with cleft palate? Why? Could this type of measure be used for treatment? Why, or why not?

5. Compare and contrast spectrography and electropalatography. Discuss the information obtained from each type of measurement and which disorders each type of instrumentation would be most useful for in terms of evaluation and treatment.

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CHAPTER FIVE THE PHONATORY SYSTEM CHAPTER OVERVIEW I. LARYNGEAL SKELETON • Bones and Cartilages • Joints of the Larynx II. VALVES WITHIN THE LARYNX • Aryepiglottic Folds • False Vocal Folds • True Vocal Folds • Cover-Body Model • Glottis III. MUSCLES OF THE LARYNX • Extrinsic Muscles • Intrinsic Muscles IV. MYOELASTIC-AERODYNAMIC THEORY OF PHONATION • Mucosal Wave • Phonation Threshold Pressure • Glottal Spectrum • Harmonic Spacing • Nearly Periodic Nature of the Human Voice V. VOCAL QUALITY • Normal Vocal Quality • Abnormal Voice Qualities o Breathy Voice o Rough/Hoarse Voice VI. VOCAL REGISTERS • Physiologic and Acoustic Characteristics of Modal, Pulse, and Falsetto Registers • Use of Different Registers in Singing and Speaking VII. ACOUSTIC MEASUREMENT OF PHONATORY VARIABLES • Frequency and Intensity Variables o Average Fundamental Frequency o Frequency Variability o Maximum Phonational Frequency Range • Voice Amplitude/Intensity o Average Amplitude Level o Amplitude Variability o Dynamic Range 27

• •

o Voice Range Profile Perturbation Measures Noise Measures KEY CONCEPTS

ADDITIVE NOISE AMPLITUDE VARIABILITY ANTERIOR COMMISSURE ARYEPIGLOTTIC FOLDS ARYTENOID CARTILAGES AVERAGE AMPLITUDE AVERAGE FUNDAMENTAL FREQUENCY BERNOULLI PRINCIPLE BREATHY VOICE CORNICULATE CARTILAGES COVER-BODY MODEL CRICOARYTENOID JOINTS CRICOID CARTILAGE CRICOTHYROID JOINTS CUNEIFORM CARTILAGES DUTY CYCLE DYNAMIC RANGE DYSPHONIA EPIGLOTTIS EXTRINSIC MUSCLES OF THE LARYNX FALSE VOCAL FOLDS

28

FALSETTO REGISTER FREQUENCY VARIABILITY GLOTTAL SPECTRUM GLOTTIS HARMONIC SPACING HARMONICS-TO-NOISE RATIO HYOID BONE HYPERADDUCTED HYPOADDUCTED INTRINSIC MUSCLES OF THE LARYNX JITTER LAMINA PROPRIA LARYNGEAL VENTRICLE LARYNX MAXIMUM PHONATIONAL FREQUENCY RANGE MEDIAL COMPRESSION MODAL REGISTER MUCOSAL WAVE MULTIPHASIC CLOSURE MUSCULAR PROCESS MYOELASTIC-AERODYNAMIC THEORY OF PHONATION PHONATION THRESHOLD PRESSURE PULSE REGISTER ROUGH/HOARSE VOICE

29

SHIMMER THRYOARYTENOID MUSCLE THYROID CARTILAGE TRUE VOCAL FOLDS VOCAL PROCESS VOCAL QUALITY VOICE RANGE PROFILE

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Review the anatomy of the laryngeal apparatus, highlighting the hyoid bone, joints, cartilages, and vocal folds. Use visuals and anatomical models to illustrate the structures and anatomical relationships.

2. Prepare a chart of the extrinsic and intrinsic muscles. Explain how the function of each muscle depends on the location of its origin and insertion and the direction in which the fibers run. Have the students prepare their own charts and include sketches of the muscles.

3. Explain the histological and biomechanical composition of the vocal folds and introduce the cover-body model.

4. Describe the myoelastic-aerodynamic theory of phonation, focusing on the interplay of positive and negative pressures during vocal fold vibration. Discuss the mucosal wave motion of the vocal folds and the role of phonation threshold pressure.

5. Demonstrate the Bernoulli principle and the effect of negative pressure by placing two textbooks of the same size on a flat surface, about 6-8 inches apart. Place a sheet of paper on top of the two books and ask a student to blow in the space under the paper. Since the air moving under the piece of paper increases in velocity, the pressure in this area decreases, causing the paper to sink downwards between the two books. Before beginning the demonstration, ask students to predict what may occur, and after seeing the result, explain why the paper dipped downward and did not blow off the two books.

6. Discuss normal voice and challenge students to develop a definition of what constitutes normal voice. Describe different vocal qualities and perceptual and acoustic bases of rough and breathy voices.

7. Define and delineate the attributes of modal, pulse, and falsetto registers and the perceptual and 30

acoustic consequences of vocal fold behavior in each register.

8. Identify commonly used vocal frequency and intensity measurements. Have students discuss how these data are useful in the clinical management of patients with communication disorders.

9. Create a lab demonstration of frequency, intensity and noise measures using Praat.

10. Describe the advantages and disadvantages of perturbation and noise measures.

CHAPTER FIVE TEST BANK MULTIPLE CHOICE QUESTIONS 1. Which of the following statements is NOT true of the arytenoid cartilages? a. They are located on the inferior surface of the cricoid cartilage. b. The vocal and muscular processes extend from the base of the arytenoid cartilages. c. They play a crucial role in phonation. d. Several muscles attach to the arytenoids, allowing them a wide range of movements.

2. What is the primary function of the cricothyroid joint? a. Permits adduction of the vocal folds. b. Permits abduction of the vocal folds. c. Regulates fundamental frequency by elongating and shortening the vocal folds. d. A & B 3. The muscle that abducts the vocal folds is the a. Lateral cricoarytenoid b. Transverse interarytenoid c. Cricothyroid d. Posterior cricoarytenoid 4. Which of the following statements best describes the mucosal wave? a. Bottom to top opening and closing of the vocal folds. b. The four phases of vocal fold movement: opening, open, closing, and closed. c. Top to bottom opening and closing of the vocal folds. d. Vocal folds recoil to midline due to their natural elasticity.

5. Which of the following statements (if any) are NOT true of phonation threshold pressure? a. It ranges from about 3 cm H20 at low frequencies to around 6 cm H20 at high frequencies. b. It is higher for louder speech and lower for softer speech. c. It is the minimum amount of subglottal pressure needed to set the vocal folds into vibration. d. All of the above statements are true.

6. What would the harmonics be for an individual who has a F0 of 100 Hz? a. 300, 500, 700 Hz 31

b. 200, 300, 400 Hz c. 150, 200, 250 Hz d. 500, 1000, 1500 Hz 7. Shimmer results from a. Differences in the amplitude of each cycle of vocal fold vibration. b. Differences in the frequency of each cycle of vocal fold vibration. c. Differences in the noise-to-harmonics ratio over time. d. Differences in the tension of the vocal folds in each cycle of vibration.

8. Identify the type of a vocal quality or vocal register described by the following statements: -Irregular vocal fold vibration resulting in a less periodic signal.

-Increase in noise at higher frequencies (>5 kHz) -Multiphasic vocal fold closure -Tight stiff vocal folds prevent complete closure during vibration. a. Pulse register b. Breathy Voice c. Rough Voice d. Falsetto register 9. Maximum phonational frequency range a. Tends to be larger in speakers who are in good physical condition. b. Reflects the physiological limits of a speaker’s voice. c. Is typically not affected by sex. d. All of the above statements are true.

10. Measurement of changing F0 levels during conversational speech corresponds to a. Average Fundamental Frequency b. Dynamic Range c. Frequency Variability d. Voice Range Profile TRUE AND FALSE QUESTIONS 1. The thyroid cartilage is the largest cartilage in the larynx and has a protrusion known as the “Adam’s apple”.

A) TRUE

B) FALSE

2. The larynx is composed of three sets of valves that open and close to perform various functions: aryepiglottic folds, false vocal folds, true vocal folds.

A) TRUE

B) FALSE

3. The vocal folds consist of six layers, including the thyroarytenoid muscle, four layers of mucous membrane, and a layer of epithelium.

A) TRUE

B) FALSE 32

4. For quiet breathing the glottis is slightly open, but opens forcefully when needing to inhale greater amounts of air.

A) TRUE

B) FALSE

5. The cricothyroid muscle elongates and tenses the vocal folds.

A) TRUE

B) FALSE

6. The Bernoulli principle helps to explain the opening motion of the vocal folds.

A) TRUE

B) FALSE

7. The vocal folds do not vibrate in a completely even, periodic manner due to their tissue and biomechanical characteristics.

A) TRUE

B) FALSE

8. The higher a speaker’s F0, the higher their pitch, the wider the harmonic spacing.

A) TRUE

B) FALSE

9. Multiphasic closure is a phenomenon seen in pulse register.

A) TRUE

B) FALSE

10. Amplitude is controlled by regulating subglottal pressure, primarily through increasing and decreasing medial compression.

A) TRUE

B) FALSE SHORT ANSWER QUESTIONS

1. Identify the two joints of the larynx and describe their structure and function.

2. Compare and contrast the structure and function of the true and false vocal folds.

3. Explain the nearly periodic nature of the vocal folds. Be sure to include information about jitter and shimmer in your response.

4. Describe the opening and closing patterns of the vocal folds during vibration, including the mucosal wave.

5. Compare and contrast breathiness and roughness in terms of perceptual and acoustic characteristics.

33

ESSAY QUESTIONS 1. Identify and describe the six parameters of normal vocal quality as defined by Zemlin.

2. Compare and contrast the physiologic and acoustic characteristics of modal, pulse, and falsetto registers.

3. Discuss the myoelastic-aerodynamic theory of phonation and the role that air pressure plays in vocal fold vibration.

4. Identify and describe two frequency variables and two amplitude variables that are useful clinical measures of phonation.

5. Discuss the advantages and disadvantages of using perturbation measures such as jitter and shimmer in a clinical situation.

CHAPTER SIX EVALUATION AND TREATMENT OF PHONATORY DISORDERS CHAPTER OVERVIEW I. ELECTROGLOTTOGRAPHY • EGG and Register • EGG Slope Quotients II. ENDOSCOPY AND VIDEOSTROBOSCOPY III. HIGH-SPEED DIGITAL IMAGING IV. VIDEOKYMOGRAPHY V. ADVANTAGES OF ACOUSTIC AND VISUAL ANALYSIS OF PHONATORY FUNCTION VI. LARYNGEAL AGING • Acoustic Changes Over the Lifespan VII. NEUROLOGICAL DISORDERS • Amyotrophic Lateral Sclerosis • Parkinson’s Disease • Unilateral Vocal Fold Paresis/Paralysis • Spasmodic Dysphonia • Paradoxical Vocal Fold Motion

34

•

Benign Mucosal Lesions, Muscle Tension Dysphonia, and/or GERD

VIII. LARYNGEAL CANCER IX. HEARING IMPAIRMENT X. TRANSSEXUAL VOICE KEY CONCEPTS ARYTENOID ADDUCTION BOTOX INJECTION BRADYKINESIA CLOSED QUOTIENT CLOSED-TO-OPEN RATIO CONTACT INDEX DEEP BRAIN STIMULATION DOPAMINE DYSPNEA ELECTROGLOTTOGRAPHY ENDOSCOPY FETAL CELL TRANSPLANTATION HIGH-SPEED DIGITAL IMAGING LARYNGOPHARYNGEAL REFLUX LARYNGOSPASMS LX WAVE MEDIALIZATION THYROPLASTY OPEN QUOTIENT

35

PARESIS PRESBYPHONIA SPEED QUOTIENT STRIDOR TOTAL LARYNGECTOMY VERTICAL PARTIAL LARYNGECTOMY VIDEOKYMOGRAPHY VIDEOSTROBOSCOPY

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Introduce electroglottography (EGG). Explain that the technique works by the differential resistance of human tissue and air to electrical current. Discuss the Lx waveform in terms of increases and decreases in voltage during vocal fold vibration.

2. Identify the relationship between EGG and vocal registers. Discuss the patterns that are seen on the Lx waveform and how these patterns are indicative of a particular vocal register.

3. Introduce EGG slope quotients, and explain how the quantitative data are obtained from comparing different phases of the duty cycle. Describe the types of vocal disorders that may be evaluated by specific quotients.

4. Describe rigid and flexible laryngeal endoscopic procedures that are used to visualize the larynx.

Discuss the advantages of using this procedure, as well as the benefits of using endoscopy in conjunction with videostroboscopy. Explain that videostroboscopy provides what is essentially an optical illusion to slow down the vibration of the vocal folds.

5. Discuss the advantages and disadvantages of high-speed digital imaging (HSDI) compared to videostroboscopy.

6. Introduce videokymography (VKG) and contrast it to stroboscopy. In your discussion, include the specific details of vocal fold patterns that are observed in VKG. 7. To set the stage for the following discussion, ask the students to describe how the information obtained from these instruments may be useful in the evaluation and treatment of phonatory disorders.

8. Discuss the anatomical changes that occur in the larynx over the lifespan. Explain the influence that these changes have on the acoustic characteristics of the human voice as the individual ages.

36

9. Examine neurological disorders that often present with phonatory problems. For each disorder, discuss the acoustic and/or anatomical features that are affected in these individuals and how acoustic and visual analysis may be used in clinical management.

10. Discuss the voicing alternatives that are available to individuals following total laryngectomy.

Compare the alternatives in terms of perceptual and acoustic characteristics.

11. Discuss the acoustics of voice in individuals with hearing impairment, and describe the effects of cochlear implantation.

12. Explore the usefulness of EGG and acoustic measures when evaluating and treating transsexual individuals with phonatory challenges.

CHAPTER SIX TEST BANK MULTIPLE CHOICE QUESTIONS 1. Which of the following statements describes an electroglottograph? a. It generates a waveform that corresponds to vocal fold movement. b. It depends upon the changing resistance to the flow of air pressure between the vocal folds. c. It measures subglottal pressure. d. All of the above.

2. In modal register, the Lx waveform would demonstrate a. A steeper closing phase than opening phase. b. A steeper opening phase than closing phase. c. An equal opening and closing phase. d. More than one peak per cycle reflecting multiphasic closure.

3. All of the following statements are true about the closed quotient EXCEPT a. It compares the duration of the closed phase to the time of the entire vibratory cycle. b. It reflects the proportion of time that the vocal folds are in contact with each other. c. It is related to the degree of medial compression being exerted. d. A higher closed quotient indicates a shorter duration of closure.

4. The peaks on an Lx waveform make it possible to determine a speakers’ a. Subglottal pressure b. Fundamental frequency c. Jitter and shimmer levels d. Amplitude 5. During puberty, which of the following occurs in males? a. F0 decreases by one octave. b. Vocal folds grow approximately 11.57 mm.

37

c. A & B d. None of the above.

6. Male alaryngeal speakers who use esophageal or tracheoesophageal speech typically present with which of the following acoustic characteristics? a. Higher than average fundamental frequency levels. b. Higher than average amplitude levels. c. Lower than average jitter levels. d. None of the above 7. Which of the following acoustic characteristics of voice is the strongest indicator of gender identification in humans? a. Fundamental frequency b. Dynamic range c. Average amplitude level d. Maximum phonational frequency range 8. For patients with unilateral vocal fold paralysis, what is the ultimate goal of treatment methods involving vocal fold injection, vocal fold medialization thyroplasty, and/or arytenoid adduction? a. Greater intonational range b. Increasing frequency variability c. Increasing glottal closure d. Greater amplitude in connected speech 9. An Lx waveform represents which of the following? a. Increases and decreases in air pressure. b. Increases and decreases in amplitude. c. Increases and decreases in electrical activity. d. Increases and decreases in subglottal pressure.

10. A disadvantage of stroboscopy is a. Inability to visualize the structure and function of the larynx. b. Irregular vocal fold vibration cannot be seen. c. Does not capture a “snapshot” of the vocal folds. d. Requires that the patient undergo general anesthesia.

11. Videokymography (VKG) is more beneficial than traditional videostroboscopy because VKG can measure a. Highly aperiodic vocal fold vibration b. Slight variations in mucosal waves c. Opening versus closing duration d. All of the above TRUE AND FALSE QUESTIONS 1. There is no Lx waveform for voiceless sounds.

A) TRUE

B) FALSE 38

2. EGG measures vocal fold contact and is a useful tool for determining the amount of noise in voice.

A) TRUE

B) FALSE

3. During connected speech, a rigid endoscope may be used to observe vocal fold function.

A) TRUE

B) FALSE

4. High-speed digital imaging allows for a detailed evaluation of vocal fold vibratory patterns because it can record and analyze each cycle of vocal fold vibration.

A) TRUE

B) FALSE

5. Research has shown that elderly speakers’ voices often demonstrate greater vocal fold instability and decreased noise levels.

A) TRUE

B) FALSE

6. High-speed digital imaging along with kymography may be used to determine the presence of paralysis that results from damage to the recurrent laryngeal nerve or superior laryngeal nerve.

A) TRUE

B) FALSE

7. Individuals with unilateral vocal fold paralysis present with increased levels of jitter, shimmer and NHR. A) TRUE

B) FALSE

8. GERD is a normal physiologic process that occurs typically after a meal and may be observed with endoscopy.

A) TRUE

B) FALSE

9. Female speakers use a wide range of fundamental frequencies and varied patterns of pitch inflections, whereas males use a more restricted fundamental frequency range and fewer inflectional patterns.

A) TRUE

B) FALSE

10. Males show a slight degree of posterior opening of the vocal folds during vibration.

A) TRUE

B) FALSE

39

SHORT ANSWER QUESTIONS 1. List three advantages of using acoustic and visual measures when evaluating and treating phonatory disorders.

2. Identify two common vocal problems for patients with Parkinson’s disease. How can instrumental measures help in the evaluation and treatment of these problems?

3. Describe two surgical procedures used to treat patients with unilateral vocal fold paralysis. How can instrumental measures be used to evaluate the outcomes of these procedures?

4. Explain the relationship between laryngopharyngeal reflux (LPR) and vocal fold function. Identify one advantage and one disadvantage of using instrumental measures to evaluate LPR. 5. Identify three ways that jitter and shimmer may be used in assessment and treatment of neurological and voice disorders.

ESSAY QUESTIONS 1. What are some of the acoustic changes a patient with early stage ALS is likely to demonstrate?

Explain how acoustic analysis is beneficial in evaluating and treating such a patient.

2. What is the “gold standard” for treating adductor spasmodic dysphonia and what are the reasons this type of treatment can be so beneficial? Which acoustic/visual measure is most useful in determining whether the treatment was successful?

3. When patients undergo a total laryngectomy, what are two alternative voicing sources that are available to them? What does an EGG reveal about these types of alternative methods?

4. Hearing impaired patients may be fitted with a cochlear implant to improve hearing abilities.

What acoustic characteristics of voice are often evident before and after the implant is turned on?

5. Draw Lx waveforms for each vocal register and explain the link between the waveform and the vocal fold vibratory pattern for each.

CHAPTER SEVEN THE RESPIRATORY SYSTEM CHAPTER OVERVIEW I. PULMONARY APPARATUS • Bronchial Tree • Chest Wall II. MUSCLES OF RESPIRATION

40

• •

Accessory Muscles of Respiration Muscles of the Abdomen

III. PLEURAL LINKAGE IV. MOVING AIR INTO AND OUT OF THE LUNGS • Inhalation • Exhalation • Rate of Breathing V. LUNG VOLUMES AND CAPACITIES • Resting Expiratory Level • Lung Volumes o Tidal Volume o Inspiratory Reserve Volume o Expiratory Reserve Volume o Residual Volume o Dead Air • Lung Capacities o Vital Capacity o Functional Residual Capacity o Inspiratory Capacity o Total Lung Capacity VI. DIFFERENCES BETWEEN BREATHING FOR LIFE AND BREATHING FOR SPEECH • Location of Air Intake • Ratio of Time for Inhalation Versus Exhalation • Volume of Air Inhaled and Exhaled per Cycle • Muscle Activity for Exhalation • Chest Wall Shape VII. SPEECH BREATHING FOR ISOLATED VOWELS AND CONNECTED SPEECH • Breathing Patterns for Speech • Changes in Speech Breathing Over the Lifespan • Features of Speech Breathing in Children • Features of Speech Breathing in Older Adults KEY CONCEPTS ACCESSORY MUSCLES OF RESPIRATION ALVEOLAR DUCTS ALVEOLAR PRESSURE

41

BRONCHIAL TREE CHEST WALL CILIA DEAD AIR END-EXPIRATORY LEVEL EXHALATION EXPIRATORY RESERVE VOLUME FUNCTIONAL RESIDUAL CAPACITY INHALATION INSPIRATORY CAPACITY INSPIRATORY RESERVE VOLUME INTRAPLEURAL PRESSURE MAINSTEM BRONCHI MUSCLES OF RESPIRATION PARIETAL PLEURA PLEURAL FLUID PLEURAL LINKAGE PLEURAL SPACE PNEUMOTHORAX PREPHONATORY CHEST WALL MOVEMENTS PULMONARY APPARATUS RECOIL FORCES RELAXATION PRESSURES RESIDUAL VOLUME 42

RESTING EXPIRATORY LEVEL SPIROMETER SURFACTANT TIDAL VOLUME TOTAL LUNG CAPACITY TRANSPULMONARY PRESSURE VISCERAL PLEURA VITAL CAPACITY

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Review the anatomy of the pulmonary apparatus and the muscles of respiration.

2. Identify the lung volumes and capacities. Use the illustration on page 241 of the text to support your lecture. This discussion will help student to understand the differences between life and speech breathing. Handheld spirometers and peak flow meters are relatively inexpensive and easily obtainable and can help students to understand the practical application of lung volumes and capacities.

3. Distinguish between breathing for life and breathing for speech. Have students breathe quietly and then switch to speech breathing to operationalize the five changes that occur when switching from one to the other.

4. Explain the concept of relaxation pressures, emphasizing the link between vital capacity, resting expiratory level, and alveolar pressure.

5. Have students sustain isolated vowels and short segments of connected speech. Focus their attention on the differences that occur in breathing during the two conditions.

6. Discuss the anatomic and physiological changes that occur over the lifespan, focusing on the changing lung volumes and capacities and potential influences on speech breathing at different ages.

43

CHAPTER SEVEN TEST BANK MULTIPLE CHOICE QUESTIONS 1. The pulmonary apparatus is made up of a. The diaphragm and trachea b. The trachea, bronchi, bronchioles, alveoli, and lungs c. The rib cage, abdomen, and lungs d. The upper respiratory system 2. The filtering process that cleans air going into the lungs is achieved by a. Surfactant within the alveoli of the lungs b. Cilia present in the tracheal epithelium c. Cartilaginous structure of the bronchi d. Tracheal flexibility 3. During exhalation a. Alveolar pressure is positive. b. Alveolar pressure is negative. c. The thoracic cavity expands. d. The diaphragm contracts and flattens.

4. Which statement is true of resting expiratory level? a. State of equilibrium in the respiratory system. b. Moment when alveolar pressure equals atmospheric pressure. c. Occurs at the end of every exhalation. d. All of the above statements are true.

5. The volume of air that can be exhaled below tidal volume is known as a. Inspiratory Reserve Volume b. Residual Volume c. Expiratory Reserve Volume d. None of the above 6. Inspiratory capacity is a. The amount of air that can be inhaled from end-expiratory level. b. The amount of air that can be inhaled above vital capacity. c. The combination of tidal volume plus expiratory reserve volume (TV + ERV) d. None of the above 7. Normal adult quiet breathing and conversational speech use approximately what percent of vital capacity, respectively? a. 10, 15 % b. 10, 20 % c. 15, 20 % d. 15, 30 %

44

8. The passive recoil forces that occur during exhalation generate pressure known as a. recoil pressure b. relaxation pressure c. alveolar pressure d. A & B 9. All of the following influence speech breathing patterns EXCEPT a. Complexity of the speaking task. b. Language being spoken by the speaker. c. Type of phoneme being uttered. d. Intended loudness of the spoken utterance.

10. Elderly adults may show which of the following characteristics? a. Large rib cage and lung volume initiation and excursions. b. Larger volumes of air expended per speech breath. c. Fewer syllables per breath. d. All of the above.

TRUE AND FALSE QUESTIONS 1. The left lung is larger than the right lung, and is composed of three lobes.

A) TRUE

B) FALSE

2. As the bronchial tree continues to subdivide, the total surface area of the smaller branches is greatly increased.

A) TRUE

B) FALSE

3. When the diaphragm contracts, the lower rib cage raises, increasing the volume of the thoracic cavity.

A) TRUE

B) FALSE

4. Positive pressure in the pleural space keeps the lungs and thorax connected and allows them to function as one unit.

A) TRUE

B) FALSE

5. During speech, the rate of recoil forces must be controlled and the inspiratory muscles must contract in order to prevent the thoracic cavity and lungs from deflating too quickly.

A) TRUE

B) FALSE

6. The abdominal muscles are only engaged during speech breathing when stressing specific syllables or speaking a louder utterance.

A) TRUE

B) FALSE 45

7. Residual volume is not under voluntary control and can never be voluntarily expired.

A) TRUE

B) FALSE

8. The abdominal wall is more efficient than the rib cage at changing lung volumes.

A) TRUE

B) FALSE

9. Voiced stops and affricates require a higher flow of air through the system than voiceless stops and fricatives.

A) TRUE

B) FALSE

10. Due to their small airways, young children tend to generate higher pressures for speech than adults.

A) TRUE

B) FALSE SHORT ANSWER QUESTIONS

1. Describe the bronchial tree and its subdivisions.

2. Discuss the differences in rate of breathing between children and adults, including the anatomical reasons for such differences.

3. Describe how changes in alveolar pressure contribute to inhalation and exhalation.

4. Discuss at least two linguistic influences that affect patterns of speech breathing.

5. Define resting expiratory level and explain its relationship to lung volumes and capacities.

ESSAY QUESTIONS 1. Describe pleural linkage, making sure to include all the anatomical structures that contribute to this mechanism.

2. Identify and discuss the five changes that occur when switching from life breathing to speech breathing.

3. Explain how speech breathing develops in children through the stages of emergence, refinement, and adaptation.

4. Discuss the anatomic and physiological changes in the respiratory system that occur during the aging process, and how such changes may affect speech breathing in older adults.

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5. Describe the role of the abdominal muscles in both inhalation and exhalation.

CHAPTER EIGHT EVALUATION AND TREATMENT OF RESPIRATORY DISORDERS CHAPTER OVERVIEW I. MEASUREMENT OF RESPIRATORY VARIABLES • Pulmonary Function Testing • Respiratory Kinematic Analysis o Plethysmography o Linearized Magnetometer • Air Pressures • Airflow II. RESPIRATORY FUNCTION AND SPEECH PRODUCTION • Classification of Respiratory Problems • Symptoms of Respiratory Disorders III. PRINCIPLES OF CLINICAL MANAGEMENT OF SPEECH BREATHING DISORDERS • Neurological Disorders o Parkinson’s Disease o Cerebellar Disease o Cervical Spinal Cord Injury o Cerebral Palsy • Mechanical Ventilation • Voice Disorders • Asthma • Paradoxical Vocal Fold Motion

KEY CONCEPTS ASTHMA CENTRAL RESPIRATORY PROBLEMS CEREBELLAR DISEASE CEREBRAL PALSY CERVICAL SPINAL CORD INJURY 47

DYSPNEA FLOW-VOLUME LOOP HYPOVENTILATION LINEARIZED MAGNOMETER MANOMETER MECHANICAL VENTILATION OBSTRUCTIVE RESPIRATORY PROBLEMS PARADOXICAL VOCAL FOLD MOTION PARKINSON’S DISEASE PLETHYSMOGRAPHY PNEUMOTACHOMETER PULMONARY FUNCTION TESTING RESPIRATORY KINEMATIC ANALYSIS RESTRICTIVE RESPIRATORY PROBLEMS STRIDOR VOICE DISORDERS AND RESPIRATION

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Introduce the respiratory variables that are assessed when evaluating respiratory function: lung volumes, air pressures and flows, and chest wall positioning and movement. Explain the relationship between each parameter and how the relationship may be used to make inferences about parameters.

2. Discuss pulmonary function testing and what it assesses. Define and describe spirometric measures, and point out those that are most commonly used. Introduce the flow-volume loop, providing illustrations and graphs to students.

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3. Introduce respiratory kinematic analysis and explain its usefulness in assessing lung volumes based on rib cage and abdominal movement. Compare and contrast plethysmographs and linearized magnetometers. Point out the location the device on the body and how this placement measures rib cage and abdominal movement.

4. Classify obstructive, restrictive, and central respiratory problems, identifying their causes and symptoms and whether inhalation and/or exhalation are affected. Distribute graphs of normal and atypical flow-volume loops. Have students determine the type of disorder represented in each graph.

5. Distinguish between stridor and dyspnea, and elaborate on which disorders are associated with each symptom. There are excellent examples of stridor on YouTube that can help students to understand how alarming this respiratory symptom can be.

6. Introduce the disorders that affect respiratory functioning. Discuss the key characteristics of each disorder that hinder effective speech breathing.

7. Divide students into groups for each speech breathing disorder discussed in Chapter 8. Students should prepare and present the following information: the anatomical structure that may be affected; how the affected structures influence speech production; a description of the speech that is characteristic of the disorder; the evaluation instruments that should be used to evaluate the patient; the respiratory findings that are consistent with the disorder; a treatment plan that would benefit their patient.

CHAPTER EIGHT TEST BANK MULTIPLE CHOICE QUESTIONS 1. Which of the following statements is NOT true? a. Lung volume, pressures and flows, and chest wall positioning are closely related to each other. b. The positioning of the chest wall results in a particular volume of air in the lungs. c. The volume of air in the lungs directly influences the pressure in the abdomen. d. It is possible to measure one parameter of respiration and make inferences about another parameter from that information.

2. In terms of spirometry, the most common parameter assessed to measure lung functioning is a. FEV1 b. FVC c. ERV d. FEF 3. Manometers are useful for determining a. The length of time a person can hold their breath. b. How efficiently a person integrates speech and breathing.

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c. The amount of pressure a person can generate and sustain for a period of time. d. The total amount of air remaining the lungs after maximum exhalation.

4. A pneumotachometer measures a. Air pressure b. Air flow c. Lung volume d. Lung capacity 5. Hypoventilation may occur due to all of the following EXCEPT a. Stroke b. Pneumonia c. Obesity d. Drugs 6. Patients with Parkinson’s disease may present with speech breathing difficulties primarily due to a. Muscle rigidity b. Muscle atrophy c. Muscle flaccidity d. Lack of muscle coordination 7. Adequate breathing for speech may be compromised due to which of the following? a. Impaired function of the respiratory muscles. b. Poor posture. c. Central nervous system damage. d. All of the above.

8. Which of the following is likely to be present in a person who is mechanically ventilated? a. Inability to produce adequate oral pressure. b. High and rapidly changing tracheal pressure. c. Extremely low tidal volumes. d. All of the above.

9. All of the following are major symptoms of paradoxical vocal fold motion EXCEPT a. Stridor on inhalation b. Cough c. Dyspnea d. Wheezing on exhalation 10. Patients with voice disorders often talk at volumes below REL, resulting in a. A greater demand on the respiratory system. b. A stiffening of the vocal folds during phonation. c. Higher tracheal pressure. d. All of the above.

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TRUE AND FALSE QUESTIONS 1. The primary symptom of asthma, as evident on the flow-volume loop, is difficulty on exhalation due to inflammation and swelling of the bronchial airways.

A) TRUE

B) FALSE

2. Respiratory kinematic analysis estimates lung volumes from rib cage and abdominal movement.

A) TRUE

B) FALSE

3. The pressures needed for speech include: alveolar pressure, subglottal pressure and oral pressure.

A) TRUE

B) FALSE

4. Dyspnea is an audible sound that occurs during inspiration and/or expiration and is a symptom of a respiratory disorder.

A) TRUE

B) FALSE

5. Damage to the cerebellum may result in speech that is slow, with all syllables produced with equal and excess stress.

A) TRUE

B) FALSE

6. Patients with ataxic cerebral palsy present with shallow inhalations and forced and uncontrolled exhalations.

A) TRUE

B) FALSE

7. A Passy-Muir speaking valve is most appropriate for patients who present with dyspnea.

A) TRUE

B) FALSE

8. Asthma is most often diagnosed with a series of pulmonary function tests.

A) TRUE

B) FALSE

9. Inhaled corticosteroids reduce inflammation, decrease excessive mucous production and are most successful when treating voice disorders.

A) TRUE

B) FALSE

10. Scanning speech is most prevalent in patients with Parkinson’s disease.

A) TRUE

B) FALSE

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SHORT ANSWER QUESTIONS 1. Why is measuring oral and nasal airflow an important factor to consider during an evaluation of respiratory functioning?

2. Discuss why the information obtained from a manometer may be useful in treating a patient with a neurological disorder or cleft palate.

3. Is it possible to gather any useful data from a person uttering a voiceless stop consonant? If yes, why and what does the information tell you?

4. Discuss the respiratory findings that are most prevalent in individuals with asthma.

5. Identify and discuss the respiratory dysfunction that is often present in individuals with voice disorders.

ESSAY QUESTIONS 1. Identify and discuss restrictive, obstructive, and central respiratory problems. In your response, include whether inhalation and/or exhalation is (are) affected, what symptoms a person may present with, and an example of a disorder for each.

2. Identify and discuss the four principles that are important when considering clinical management and treatment of patients presenting with speech breathing difficulties.

3. Discuss the importance of addressing chest wall shape in children with cerebral palsy. What are some treatment strategies that have shown to be beneficial for children with this disorder?

4. Compare and contrast the differing evaluation and treatment methods for a patient with asthma and a patient with paradoxical vocal fold motion. Draw a flow-volume loop for each disorder.

5. Discuss the respiratory breakdowns and speech characteristics that an individual with cerebellar disease may present with.

CHAPTER NINE THE AUDITORY SYSTEM CHAPTER OVERVIEW I. OUTER EAR II. TYMPANIC MEMBRANE III. MIDDLE EAR • Eustachian Tube • Ossicles • Muscles of the Middle Ear

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•

Functions of the Middle Ear

IV. INNER EAR • Cochlea • Basilar Membrane • Cochlear Function V. PERCEPTION OF SPEECH • Segmentation Problem • Role of Redundancy in Speech Perception • Instrumental Analysis of Vowel and Consonant Perception VI. PERCEPTION OF VOWELS AND DIPHTHONGS • Vowels • Diphthongs VII. CONSONANTS • Categorical Perception • Multiple Acoustic Cues • Influence of Coarticulation VIII. PERCEPTION OF CONSONANTS • Liquids • Glides • Nasals • Stops • Fricatives • Affricates IX. HEARING LOSS • Hearing Loss and Speech Perception

KEY CONCEPTS ACOUSTIC CUES AUDIBILITY AUDITORY NERVE BASILAR MEMBRANE CATEGORICAL PERCEPTION 53

COARTICULATION COCHLEA COCHLEAR DUCT CUTBACK CROSSOVER DIPHTHONG PERCEPTION ENDOLYMPH EUSTACHIAN TUBE EXTERNAL AUDITORY MEATUS INNER EAR MIDDLE EAR ORGAN OF CORTI OSSICLES OUTER EAR PATTERN PLAYBACK PERILYMPH REISSNER’S MEMBRANE RISE TIME STAPEDIUS STEREOCILIA SUPRATHRESHOLD RECOGNITION ABILITY TARGET UNDERSHOOT TENSOR TYMPANI

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TYMPANIC MEMBRANE VOWEL PERCEPTION

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Review basic terms and anatomy of the auditory system. Explain the importance of each structure in terms of its role and function in the hearing process.

2. Examine the functions of the middle ear and the concept of impedance.

3. Identify the significance of the cochlea and Organ of Corti, and explain the tonotopic organization of the basilar membrane. Animations of middle ear and basilar functions are available on the web.

4. Discuss the changes that occur as sound waves are converted into different forms of energy beginning at the source of vibration and leading to the auditory nerve. There are several excellent videos on YouTube that show animations of the transduction process and the anatomical structures involved.

5. Introduce the concept of speech perception and the factors that influence how listeners perceive speech.

6. Define the acoustic-phonemic knowledge that has been studied to better understand how listeners are able to perceive the acoustic features of a sound and transform that knowledge into the perception of a distinct phoneme. Explain the historic contribution of the Pattern Playback in demonstrating this phenomenon.

7. Discuss the role of categorical perception, multiple acoustic cues, and the influence of coarticulation in speech perception.

8. Examples and demonstrations of categorical perception are available on the Internet. Play a demonstration for the students and ask them to judge the identity of the phoneme pairs. Compare notes after this exercise to see how consistent the students were in their judgments.

9. Identify the factors that impact perception in speakers with hearing impairment. Explain why certain phonemes are acoustically more difficult to perceive.

CHAPTER NINE TEST BANK MULTIPLE CHOICE QUESTIONS 1. Which of the following structures is responsible for transducing pressure waves into mechanical vibration?

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a. Tensor Tympani b. Pinna c. Oval window d. Tympanic Membrane 2. Which of the following statements is NOT true of the Eustachian tube? a. It keeps the middle ear space ventilated. b. It aids in equalizing pressure between the middle ear and the atmosphere. c. It runs from the nasopharynx into the middle ear. d. It is normally open, except during a yawn or swallow.

3. Which of the following statements is true about the cochlea? a. It contains the organ of Corti. b. It is important in regulating balance. c. It transduces air pressures into mechanical energy. d. It aids in equalizing air pressure within the tympanic cavity.

4. When the stapedius muscle fatigues it becomes less effective at a. Transmitting sound. b. Contracting in order to pull the ossicles inward. c. Damping loud sounds. d. Amplifying low frequency sounds.

5. The basilar membrane a. Has a differential frequency response. b. Sends impulses to the brain stem. c. Attenuates loud sounds. d. Changes pressure waves into mechanical vibrations.

6. Crossover suggests that a. Vowels and consonants are perceived categorically. b. Listeners are unable to distinguish small acoustic differences in phonemes. c. A listener may have difficulty discriminating between /b/ and /p/. d. A & B 7. Which of the following statements (if any) is NOT true about speech perception of hearing impaired individuals? a. Many adults with hearing impairment are able to discriminate between vowels. b. Many children with hearing impairment have difficulty in discriminating between vowels. c. Individuals with high frequency losses typically have difficulty identifying fricatives. d. All the above statements are true.

8. Vowels are easy for listeners to identify because a. Vowel formant frequencies are always the same for individual speakers b. There is no overlap in formant frequencies for different vowels. c. There is a one-to-one correspondence between vowels and their formant frequencies d. None of the above is true 56

9. Target undershoot occurs when a. A speaker begins saying the following phoneme before completing the previous sound. b. A listener hears a different phoneme from the one that was actually uttered. c. The formant patterns of different vowels become similar to each other. d. A listener differentiates between the formants of an affricate and a fricative.

10. All of the following are cues to identifying a stop consonant EXCEPT a. Brief interval of silence. b. Transient burst of noise. c. Intensity of the burst. d. Rapid formant transition between the stop and a preceding/following vowel.

TRUE AND FALSE QUESTIONS 1. The main function of the external auditory meatus is to localize sound and channel the sound waves into the ear canal.

A) TRUE

B) FALSE

2. The basal portion of the basilar membrane responds to all frequencies, but its high degree of stiffness makes it most responsive to high frequencies.

A) TRUE

B) FALSE

3. The manubrium connects to the stapes, which in turn connects to the incus, which inserts into the oval window.

A) TRUE

B) FALSE

4. Adolescents are susceptible to middle ear infections because their Eustachian tubes run nearly horizontally, so fluids do not drain easily.

A) TRUE

B) FALSE

5. Contextual and linguistic information serve to enhance speech perception and the decoding of an acoustic signal into meaningful units.

A) TRUE

B) FALSE

6. Humans focus solely on the formant frequencies of a vowel in connected speech to determine which vowel the speaker is producing.

A) TRUE

B) FALSE

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7. Glides are characterized by formant transitions that are shorter in duration than those of diphthongs.

A) TRUE

B) FALSE

8. Hearing impaired individuals often cannot recognize phonemes even though they are audible, due to loss of suprathreshold discriminability.

A) TRUE

B) FALSE

9. The substance that is secreted in the external auditory meatus is known as cerumen.

A) TRUE

B) FALSE

10. Adults with acquired hearing loss have greater difficulty recognizing sounds than those with congenital hearing loss.

A) TRUE

B) FALSE SHORT ANSWER QUESTIONS

1. Explain the significance of the ear canal being a quarter-wave resonator and its role in amplifying high-frequency sounds.

2. Discuss two functions of the Eustachian tube that affect middle ear functioning.

3. Explain the acoustic reflex, noting which structure(s) is/are involved in this reflex and its role in sound intensity.

4. Discuss the acoustic features that enable listeners to distinguish between liquids and fricatives.

5. What is the segmentation problem that exists in relation to perception of speech?

ESSAY QUESTIONS 1. Describe the function of the middle ear and how it overcomes the impedance mismatch between the middle and inner ears.

2. What does it mean when an individual with a hearing loss says they are able to “hear” speech but have difficulty “understanding” it? Why does this occur?

3. Explain the concept of categorical perception and its role in recognizing and identifying consonants.

4. Discuss why the acoustic features of /s/ are difficult to perceive for individuals with a hearing loss and how this may affect their communication.

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5. Explain the “redundancy” in speech perception and how it influences the ability to recognize acoustic cues.

CHAPTER TEN EVALUATION AND TREATMENT OF DISORDERS RELATED TO HEARING IMPAIRMENT CHAPTER OVERVIEW ∫I. MEASUREMENT OF AUDITORY VARIABLES • Immittance Audiometry • Tympanometry o Tympanometric Procedure o Tympanogram Shapes o Advantages of Tympanometry • Static-Acoustic Middle Ear Admittance • Acoustic Reflex Testing • Otoacoustic Emissions Testing o Spontaneous and Evoked Otoacoustic Emissions • Auditory Brain Stem Response Testing II. EVALUATION OF SPEECH PERCEPTION III. COCHLEAR IMPLANTS • Training for Cochlear Implant Users IV. OTITIS MEDIA AND SPEECH PERCEPTION V. LANGUAGE AND READING DISABILITY AND SPEECH PERCEPTION VI. ARTICULATORY PROBLEMS AND SPEECH PERCEPTION

KEY CONCEPTS ACOUSTIC REFLEX TESTING AUDITORY BRAIN STEM RESPONSE TESTING CONDUCTIVE HEARING LOSS DEVELOPMENTAL DYSLEXIA IMMITTANCE 59

OTOACOUSTIC EMISSIONS TESTING SENSORINEURAL HEARING LOSS SPECIFIC LANGUAGE IMPAIRMENT TEMPORAL PROCESSING PROBLEM TYMPANOMETRY TYMPANOMETER TYPE A TYMPANOGRAM TYPE AD TYMPANOGRAM TYPE AS TYMPANOGRAM TYPE B TYMPANOGRAM TYPE C TYMPANOGRAM EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Distinguish between conductive and sensorineural hearing loss, focusing on the specific structures involved in each.

2. Introduce the evaluation methods commonly used to assess middle ear function: tympanometry, static-acoustic middle ear admittance, and acoustic reflex testing. For each method include information about what each test assesses and how this information can be used to pinpoint the breakdown in the auditory system.

3. Review tympanogram shapes. Explain the x-values (pressure) and y-values (admittance) on the graph to help students interpret the information.

4. Introduce methods to evaluate inner ear and auditory nerve pathway function: otoacoustic emissions testing and auditory brain stem response testing. For each method include information about what each test assesses and how this information can be used to pinpoint the breakdown in the auditory system.

5. Discuss the importance of evaluating speech perception in individuals with impaired auditory functioning. Relate the evaluation to the acoustic characteristics of vowels and consonants.

6. Explain how cochlear implants work in terms of the spectral information that is coded within the electrodes. Discuss the relationship between the electrodes and speech perception. Encourage students to think about how this foundational information can be used to develop and evaluate clinical approaches to enhancing speech perception and production in cochlear implant users.

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7. Examine the benefits and drawbacks of cochlear implantation. List the hierarchy for training a cochlear implant user; beginning with a combination of visual feedback and auditory discrimination, progressing to auditory input without visual feedback, and then training the segmental and suprasegmental levels of conversational speech.

8. Explain how otitis media can result in a temporary conductive hearing loss and how this can affect a child’s language abilities and academic functioning.

9. Play simulated hearing losses for students to listen to. Hearing aid companies such as Starkey and Phonak have hearing loss simulators on their websites that provide simulations of normal hearing and mild, moderate, and severe losses.

10. Explain the relationship between speech perception and disabilities such as specific language impairment and developmental dyslexia.

11. Describe the link between articulatory problems and speech perception in children. Provide examples of common misarticulations. Differentiate between children with speech-perception difficulties and children with normal speech-perception skills, emphasizing the importance of this distinction for therapeutic purposes.

CHAPTER TEN TEST BANK MULTIPLE CHOICE QUESTIONS 1. Admittance of the middle ear is greatest when a. Air pressure in the ear canal is higher than in the middle ear. b. Air pressure in the ear canal is equal to air pressure in the middle ear. c. Air pressure in the ear canal is lower than in the middle ear. d. Air pressure changes rapidly in the middle ear.

2. A Type C tympanogram is indicative of a. Normal pressure within the middle ear. b. Positive pressure within the middle ear. c. Negative pressure within the middle ear. d. Otosclerosis.

3. Auditory brain stem response testing assesses which of the following? a. Inner ear functioning only. b. Auditory nerve functioning only. c. Auditory nerve and brain stem functioning. d. Inner ear, auditory nerve and brain stem functioning.

4. All of the following are diagnostic benefits of using evoked otoacoustic emissions (EOAEs) EXCEPT a. They are used in neonatal screenings to identify hearing problems in infants.

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b. They can measure recovery of conductive function after a patient undergoes treatment. c. They can identify a mild degree of sensory hearing loss in individuals. d. They are easy to assess because they do not rely on any incoming auditory stimulation.

5. Which of the following statements is NOT true of otitis media? a. It results in a mixed hearing loss. b. It is common in young children. c. It can result from fluid build-up in the middle ear. d. It can result from an upper respiratory infection.

6. Children with language-learning difficulties a. Demonstrate subtle delays in perceptual processing. b. Require a longer voice onset time to differentiate voiced from voiceless stops. c. Present with difficulties processing rapid acoustic signals. d. All of the above.

7. Children with a functional articulation disorder a. May or may not have underlying speech perception difficulties. b. Frequently have underlying speech perception difficulties. c. Rarely have underlying speech perception difficulties. d. Have speech perception difficulties with /w/ and /r/ only.

8. Acoustic reflex testing assesses a. Contraction of the stapedius muscle. b. Movement of the tensor tympani muscle. c. The cochlea’s outer hair cell response to acoustic stimuli. d. Stiffness of the tympanic membrane.

9. The most widely used tool to assess neonatal hearing is a. Auditory brainstem response testing. b. Acoustic reflex testing. c. Otoacoustic emissions testing. d. Tympanometry 10. Auditory discrimination of small acoustic differences a. Is more important for learning language in typically developing children. b. Is more important for learning language in children with language problems. c. Is equally as important for learning language in typical and language-learning disabled children. d. Is not related to language learning.

TRUE AND FALSE QUESTIONS 1. Listeners with normal hearing have acoustic reflex thresholds between 85 dB SPL and 100 dB SPL. A) TRUE

B) FALSE 62

2. Some children are able to perceive the sounds they misarticulate without a problem.

A) TRUE

B) FALSE

3. Children with specific language impairment have significant problems in the area of morphology.

A) TRUE

B) FALSE

4. Children with developmental dyslexia would benefit from very short and very rapid presentation of stimuli.

A) TRUE

B) FALSE

5. Phonemic contrast is still maintained if a child misarticulates /w/ for /r/ and /j/ for /l/.

A) TRUE

B) FALSE

6. Children with a history of otitis media with effusion (OME) perform similarly to children without OME in phonetic perception.

A) TRUE

B) FALSE

7. Spontaneous otoacoustic emissions are more effective than evoked otoacoustic emissions at detecting sensory hearing loss.

A) TRUE

B) FALSE

8. Presentation of phonetically balanced monosyllabic word lists is often part of an audiological evaluation.

A) TRUE

B) FALSE

9. Training on suprasegmental aspects of speech for cochlear implant users can help to increase phoneme and word recognition.

A) TRUE

B) FALSE

10. Contraction of the stapedius muscle in response to loud noise is known as spontaneous otoacoustic emission.

A) TRUE

B) FALSE SHORT ANSWER QUESTIONS

1. Identify and describe two methods of coding speech information in cochlear implants.

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2. Describe the training hierarchy of speech recognition suggested for individuals who have been fitted with a cochlear implant.

3. Compare and contrast the speech perception difficulties of a child with SLI and a child with developmental dyslexia.

4. Describe the method of acoustic reflex testing. What information does this test provide?

5. Discuss which test(s) is (are) used to assess the auditory system functioning of a newborn.

ESSAY QUESTIONS 1. Draw the five different types of tympanograms and explain the function of the tympanic membrane for each type.

2. Discuss the relationship between a history of otitis media and phonetic perception abilities in children.

3. A link between perceptual processing difficulties and grammatical function has been found in children with SLI. Discuss how this relates to their knowledge and production of various morphological features in speech. Include the features that pose the greatest difficulty in terms of their acoustic characteristics.

4. Define otoacoustic emissions (OAEs). Compare and contrast spontaneous and evoked OAEs, and explain the diagnostic benefits of each type.

5. Discuss the link between perceptual processing difficulties and articulation in young children.

CHAPTER 11 THE NERVOUS SYSTEM CHAPTER OVERVIEW I. BRAIN TISSUE • Glial Cells • Neurons o Types of Neurons o Sensory Receptors o Neuronal Function o Conduction Velocity II. CENTRAL NERVOUS SYSTEM • Central Nervous System • Meninges • Ventricles • Functional Brain Anatomy 64

• •

•

Cortex Lobes of the Brain o Frontal Lobe o Parietal Lobes o Temporal Lobes o Occipital Lobe o Limbic Lobe Cortical Connections o Commissural Fibers o Association Fibers o Projection Fibers

III. SUBCORTICAL AREAS OF THE BRAIN • Basal Nuclei • Thalamus • Hypothalamus IV. BRAIN STEM • Midbrain • Pons • Medulla V. CEREBELLUM VI. SPINAL CORD • Spinal Nerves VII. CRANIAL NERVES • CN V: Trigeminal • CN VII: Facial • CN VIII: Vestibulocochlear • CN IX: Glossopharyngeal • CN X: Vagus • CN XII: Hypoglossal IX. BLOOD SUPPLY TO THE BRAIN X. THE LANGUAGE ZONE XI. MOTOR CONTROL SYSTEMS INVOLVED IN SPEECH PRODUCTION • Motor Cortex • Upper and Lower Motor Neurons • Direct and Indirect Systems • Motor Units

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XII. PRINCIPLES OF MOTOR CONTROL • Feedback and Feedforward • Efference Copy

KEY CONCEPTS ACTION POTENTIAL AFFERENT AMYGDALA ARACHNOID MATER ASTROCYTES AXON BASAL NUCLEI BRAIN STEM CAUDATE NUCLEUS CENTRAL NERVOUS SYSTEM CENTRAL SULCUS CEREBELLUM CEREBRAL PEDUNCLES CEREBROSPINAL FLUID CHOROID PLEXUS CELLS CIRCLE OF WILLIS CORONA RADIATA CORPUS CALLOSUM CORTEX CORTICONUCLEAR TRACT

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CORTICOSPINAL TRACT CRANIAL NERVES DENDRITES DURA MATER EFFERENCE COPY EFFERENT EXCITATORY POST-SYNAPTIC POTENTIAL EXTRAPYRAMIDAL SYSTEM FACIAL NERVE FASCICULI FEEDBACK FEEDFORWARD FINAL COMMON PATHWAY FRONTAL LOBE GLIAL CELLS GLOBUS PALLIDUS GLOSSOPHARYNGEAL NERVE GOLGI APPARATUS GYRI HIPPOCAMPUS HOMUNCULUS HYPOGLOSSAL NERVE HYPOTHALAMUS INFERIOR COLLICULI 67

INHIBITORY POST-SYNAPTIC POTENTIAL INTERNAL CAPSULE INTERNEURONS LANGUAGE ZONE LATERAL SULCUS LIMBIC LOBE LIMBIC SYSTEM LONGITUDINAL CEREBRAL FISSURE LOWER MOTOR NEURON MEDULLA MENINGES MICROGLIA MITOCHONDRIA MOTOR CORTEX MYELIN SHEATH NEOCORTEX NEUROMUSCULAR JUNCTION NEURONS NEUROTRANSMISSION NISSL BODIES NODES OF RANVIER OCCIPITAL LOBE OLIGODENDROCYTES PARIETAL LOBES 68

PERIPHERAL NERVOUS SYSTEM PIA MATER PONS PUTAMEN PYRAMIDAL SYSTEM REPOLARIZATION RESTING MEMBRANE POTENTIAL RETICULAR ACTIVATING SYSTEM RETICULAR FORMATION SCHWANN CELLS SOMA SOMATOTOPIC ORGANIZATION SPATIAL SUMMATION SPINAL CORD SPINAL NERVES STRIATUM SUBARACHNOID SPACE SUBDURAL SPACE SUBSTANTIA NIGRA SUPERIOR COLLICULI SULCI SYNAPSE TEMPORAL LOBES TEMPORAL SUMMATION 69

TERMINAL BUTTONS TERMINAL BRANCHES TRIGEMINAL NERVE THALAMUS UPPER MOTOR NEURON VAGUS NERVE VENTRICLES VESTIBULOCOCHLEAR NERVE

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Differentiate between glial cells and neurons. Describe the structure of a neuron, ways of classifying neurons, and types of sensory receptors.

2. Introduce the concepts of neurotransmission and neuroconduction.

3. Discuss action potentials, and compare excitatory and inhibitory post-synaptic potentials. Use a graph of an action potential to illustrate the concepts of resting membrane potential, depolarization, and repolarization. There are excellent simulations of action potentials on the web.

4. Review the structure and function of each part of the central nervous system: the meninges and ventricles, the cortex, cerebrum, basal nuclei, thalamus, brain stem, limbic system, cerebellum and spinal cord. Distribute photocopies of the illustrations on pages 355 and 356 of the text with the names of structures in the tables blanked out, and have the students fill them in.

5. In your discussion of the cortex, emphasize the primary function of each of the lobes of the brain, as well as the cortical connections that allow communication between cortical and subcortical structures. Introduce the concept of the motor and sensory homunculus.

6. Review the spinal and cranial nerves and explain the different types of fibers associated with these nerves. Focus on the cranial nerves most relevant to speech and hearing.

7. Create a blank chart, similar to Table 11.10 on page 375. Have students complete the chart, listing the name of the nerve, type of fiber(s), whether the nerve is sensory and/or motor, and which structure(s) the nerve innervates. Ask students to hypothesize what would occur if certain portions of each nerve were damaged and how this might affect an individual’s speech and/or swallowing.

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8. Describe the blood supply to the brain, indicating the arteries that make up the Circle of Willis.

Have students develop a chart of the arteries that corresponds to the illustration on page 376 of the text.

9. Identify the motor control systems involved in speech production in terms of the upper and lower motor neurons, and direct and indirect systems. Differentiate between the corticonuclear and corticospinal tracts. Explain the concept of motor units and define the term neuromuscular junction. Compare the way that muscles contract to the way that nerves fire, and identify the three types of motor units. There are many animations of the mechanism of muscle contraction on YouTube that facilitate understanding of the process.

10. Discuss the principles of motor control and contrast feedback and feedforward. Explain how each of these, in conjunction with efference copy, is involved in voluntary movement control.

CHCHAPTER ELEVEN TEST BANK MULTIPLE CHOICE QUESTIONS 1. The main functions of glial cells include a. Metabolic support and insulation b. Secretion of cerebrospinal fluid and response to injury c. Removing waste products of metabolism. d. All of the above.

2. Within the human nervous system, most neurons are a. Bipolar b. Unipolar c. Multipolar d. None of the above 3. All of the following statements are true about neurons EXCEPT a. Neurons communicate by means of an electrochemical process. b. Neurons go through depolarization and repolarization. c. Neurotransmission can lower or raise the threshold of the post-synaptic neuron making it easier or more difficult to fire. d. Neurons bring nutrients from the blood vessels to each glial cell.

4. Which of the following statements is true about the central nervous system? a. It is involved in aspects of information processing, including planning, organization, memory and language. b. It is made up of 12 pairs of cranial and 31 pairs of spinal nerves. c. It transmits and receives nerve impulses to and from muscles and glands in the body. d. All of the above statements are true.

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5. Cerebrospinal fluid a. Circulates around the brain and spinal cord, creating a shock-absorbing system. b. Contains proteins and glucose that provide energy for cell function. c. Reduces the weight of the brain from 1400g in air to 45g in fluid. d. All of the above.

6. The brain is divided into four major lobes by way of the a. Longitudinal cerebral fissure and corpus callosum. b. Central sulcus and lateral fissure. c. Third and fourth ventricles. d. Sulci and gyri.

7. Which lobe of the brain is responsible for language expression, reasoning, and problem solving? a. Frontal lobe b. Parietal lobe c. Temporal lobe d. Occipital lobe 8. The parietal lobes a. Are located on the precentral gyrus. b. Are associated with bodily sensation. c. Contain the premotor and supplementary motor areas. d. All of the above.

9. Which of the following structures are associated with the limbic system? a. Thalamus and hypothalamus b. Basal nuclei and cortex c. Cerebellum and brain stem d. None of the above 10. Damage to the basal nuclei may result in a. Tics and tremors b. Decreased muscle tone and flaccidity c. Excessive involuntary movements d. A & C 11. All of the following statements are true about the cerebellum EXCEPT a. It receives sensory, proprioceptive and vestibular information. b. It sends motor information to the thalamus and motor areas of the cerebral cortex. c. It exerts contralateral control of movement. d. Its hemispheres are connected by the vermis.

12. The trigeminal nerve a. Is made up of the ophthalmic, maxillary and mandibular branches. b. Supplies nerve impulses to the muscles of facial expression. c. Contains only a motor branch. d. Innervates the muscles of the soft palate and the pharynx.

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13. Special visceral efferent nerves a. Transmit information from senses including hearing, equilibrium, vision, and taste. b. Carry motor commands to specific voluntary muscles. c. Are also known as branchial motor fibers. d. B & C 14. The cranial nerve that plays a vital role in heart rate, endocrine function, digestion and phonation is a. CN VII b. CN IX c. CN X d. CN XII 15. The recurrent laryngeal nerve a. Descends into the chest and then ascends to enter the larynx. b. Innervates all the intrinsic muscles of the larynx, except for the cricothyroid. c. Damage to this nerve can result in vocal fold paralysis. d. All of the above 16. Why is the Circle of Willis so important to brain function? a. It transmits neural information to the cerebral cortex. b. It provides blood to the brain through a series of arteries. c. It is part of the language zone that contributes to speech comprehension. d. It supports the motor portion of cranial nerves.

17. Nerve cell bodies and axons of cranial and spinal nerves that connect with voluntary muscles are part of the a. Upper motor neuron b. Lower motor neuron c. Motor unit d. None of the above 18. Which of the following statements is NOT true of the corticospinal tract? a. Fibers synapse directly onto motor nerve cells in the anterior horn of the spinal cord. b. Most fibers in this tract decussate in the medullary pyramids and continue contralaterally. c. Fibers arise from the primary motor cortex as well as the primary sensory cortex. d. Fibers project to the basal nuclei, thalamus, reticular formation and sensory nuclei.

19. Damage to the pyramidal system may result in a. Weakness and/or spasticity. b. Abnormal involuntary movements, such as tics or tremors. c. Postural deficits. d. Uncoordinated, jerky movements.

20. The principle of feedforward is significant when understanding speech production because a. It allows an individual to detect and correct errors in his or her speech production. b. It is a form of auditory information that benefits young children learning language.

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c. It allows articulatory movements to be modified quickly, resulting in a great deal of precision during speech production. d. It provides auditory, proprioceptive and tactile information to a speaker.

TRUE AND FALSE QUESTIONS 1. An axon extends from the cell body and transmits nerve impulses away from the cell body.

A) TRUE B) FALSE 2. When a neuron is at rest there is a higher concentration of positive ions outside the cell and a higher proportion of negative ions within the cell.

A) TRUE

B) FALSE

3. After a nerve fires, there is a brief period of time during which it cannot be stimulated, no matter how strong the incoming impulse.

A) TRUE

B) FALSE

4. Cerebrospinal fluid circulates within the subdural space, between the dura mater and arachnoid mater.

A) TRUE

B) FALSE

5. The four ventricles of the brain contain choroid plexus cells, which are manufactured through blood flow.

A) TRUE

B) FALSE

6. The lobes in the left and right hemisphere are not mirror images of each other in terms of structure and function.

A) TRUE

B) FALSE

7. The motor strip devotes equal areas of cortical tissue to represent various body structures.

A) TRUE

B) FALSE

8. The temporal lobe is essential for decoding and comprehension of speech.

A) TRUE

B) FALSE

9. The arcuate fasciculus is an association pathway that connects Broca’s area and Wernicke’s area.

A) TRUE

B) FALSE

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10. The corpus callosum connects different cortical regions within the same hemisphere.

A) TRUE

B) FALSE

11. Dopamine, a neurotransmitter present in the basal nuclei, is involved in refining the initial neuromuscular output from the cortex.

A) TRUE

B) FALSE

12. The thalamus sorts and interprets neural information and decides which signals should be transmitted to the cranial nerves.

A) TRUE

B) FALSE

13. The brain stem is the point of origin for the cranial nerves.

A) TRUE

B) FALSE

14. Damage to the cerebellum may result in lack of fine coordination, causing jerky movements.

A) TRUE

B) FALSE

15. Each spinal nerve contains a sensory and a motor portion.

A) TRUE

B) FALSE

16. CN VII receives both ipsilateral and contralateral innervation, unlike other cranial nerves.

A) TRUE

B) FALSE

17. The pharyngeal nerve is a branch of the trigeminal nerve.

A) TRUE

B) FALSE

18. Language is not restricted to the “language zone”, but is distributed throughout the brain.

A) TRUE

B) FALSE

19. Speech production relies on both open-loop and closed-loop feedback systems.

A) TRUE

B) FALSE

20. Efference copy signals provide information to the brain stem to evaluate movement and correct any errors that may have occurred.

A) TRUE

B) FALSE

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SHORT ANSWER QUESTIONS 1. Compare and contrast the structure and function of glial cells and neurons.

2. Explain how a nerve fires in terms of depolarization and repolarization.

3. Discuss the difference between an excitatory post-synaptic potential and an inhibitory postsynaptic potential.

4. Describe the meninges and their role in protecting the brain and spinal cord.

5. Explain somatotopic organization and the motor homunculus.

6. Explain the significance of the hippocampus and amygdala in terms of their influence on human communication.

7. What is the reticular activating system? Where is it located and what functions is it involved in?

8. Discuss the anatomy of the “language zone” and how language processing has been confirmed to occur in this part of the brain.

9. Describe the three types of motor units and how they relate to the size principle.

10. Compare and contrast the principles of feedback and feedforward and their relationship to speech production.

ESSAY QUESTIONS 1. Describe the cortex of the brain, focusing on the lobes, gyri, sulci and fissures. Include a discussion of the Brodmann areas that are important for speech, language, and hearing.

2. Explain the neuromuscular events that occur when a speaker produces the phoneme /t/. Include information about the articulators, muscles, and nerve pathways that are involved.

3. Distinguish between commissural and association fibers and provide an example of each type of fiber.

4. Describe the following subcortical areas of the brain in terms of structure and function: basal nuclei, thalamus, hypothalamus.

5. Compare and contrast the cerebellum and the cerebrum in terms of structure and function.

6. Discuss the spinal nerves, providing information about their sensory and motor pathways.

7. Create a chart of the cranial nerves that are most important for speech and hearing. In your chart, provide the following information: The number and name of the nerve, any associated fibers, sensory and/or motor portions, and which structures are innervated by the nerve.

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8. Compare and contrast upper motor neurons and lower motor neurons, including the major pathways associated with each.

9. Describe the recurrent laryngeal nerve and explain the effects of damage to this nerve on vocal function.

CHAPTER 12 BRAIN IMAGING IN THE EVALUATION AND TREATMENT OF DISORDERS OF THE NERVOUS SYSTEM CHAPTER OVERVIEW I. TECHNIQUES FOR IMAGING BRAIN STRUCTURE • Computerized Tomography • Magnetic Resonance Imaging II. TECHNIQUES FOR IMAGING BRAIN FUNCTION • Functional Magnetic Resonance Imaging • Positron Emission Tomography • Single Photon Emission Computed Tomography • Electroencephalography and Evoked Potentials • Transcranial Magnetic Stimulation III. USE OF BRAIN IMAGING TECHNIQUES IN COMMUNICATION DISORDERS • Stuttering • Stroke • Parkinson’s Disease • Multiple Sclerosis • Alzheimer’s Disease

KEY CONCEPTS COMPUTERIZED TOMOGRAPHY ELECTROENCEPHALOGRAPHY EVOKED POTENTIALS FUNCTIONAL MAGNETIC RESONANCE IMAGING

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HEMODYNAMIC RESPONSE MAGNETIC RESONANCE IMAGING P300 EVOKED POTENTIAL POSITRON EMISSION TOMOGRAPHY QUANTITATIVE EEG SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY TRACER TRANSCRANIAL MAGNETIC STIMULATION

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Identify the techniques used for imaging brain structure. There are many CT and MRI images available on the web that will be helpful in showing students the different images that are produced by each technique. Identify the advantages and disadvantages of each technique.

2. Compare and contrast the techniques for imaging brain function. Check the web for examples and images of fMRI, PET scans, and SPECT scans. Identify the advantages and disadvantages of each technique.

3. Compare and contrast evoked potentials such as the P300, and transcranial magnetic stimulation.

4. Discuss how brain imaging techniques can be applied to communication disorders.

4. Assign a communication disorder (stuttering, stroke, Parkinson’s disease, multiple sclerosis, Alzheimer’s disease, or others) to groups of students. Have each group research and present the anatomical features and communication characteristics associated with the disorder. The presentation should include illustrations of brain structure and brain function related to the disorder, and the group should discuss how the brain imaging techniques contribute to clinical management.

CHCHAPTER TWELVE TEST BANK MULTIPLE CHOICE QUESTIONS 1. Transcranial magnetic stimulation a. Is based on inducing weak electric currents in the brain to cause neurons to fire.

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b. Is good for detecting tissue abnormalities. c. Measures tiny metabolic changes that take place in active parts of the brain. d. Uses radio waves to create images of organs and tissues.

2. What is one of the major disadvantages of PET? a. Relatively slow scanning time. b. Higher radiation than SPECT. c. Less fine spatial resolution producing less detailed images. d. No reported disadvantages.

3. Which of the following statements best describes EEG? a. Detects changes in blood flow and oxygen levels in response to neural activity. b. Examines blood flow through the veins and arteries in the brain. c. Shows mental and cognitive processes in the brain through blood flow. d. Detects abnormalities by recording electrical potentials generated by the brain.

4. All of the following statements are true of fMRI EXCEPT a. It can be used in conjunction with MRI. b. It can be used to treat selected psychiatric disorders. c. It is safe and noninvasive. d. It can assess how brain function changes over time.

5. The main difference between PET and SPECT is a. PET examines blood flow and SPECT does not. b. Only PET can determine differences in cognitive functioning. c. SPECT has a higher radiation because the isotopes used have longer half-lives. d. Only SPECT images can be used with CT or MRI scans.

6. The use of a radioactive tracer that emits positrons is often done with a. Positron Emission Tomography b. Electroencephalography c. Transcranial Magnetic Stimulation d. Functional Magnetic Resonance Imaging 7. Magnetic resonance imaging a. Is based on identification of a tracer in the brain. b. Is based on the behavior of hydrogen atoms in response to radio frequencies. c. Is based on weak electric currents that cause neurons to fire. d. None of the above.

8. In PET, positrons collide with electrons, producing which of the following rays? a. Alpha rays b. Beta rays c. Delta rays d. Gamma rays 9. CT images are useful for examining injuries because a. They provide images of cortical and subcortical regions of the brain.

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b. They provide detailed three-dimensional images. c. They provide images of bones and soft tissues of the body. d. All of the above.

10. The hemodynamic response is measured by a. PET b. fMRI c. SPECT d. TMS 11. Individuals who stutter have shown a. Decreased activity in the supplementary motor area. b. Extensive hyperactivity of the motor system. c. Increased activity in the striatum and globus pallidus. d. None of the above.

12. Longitudinal studies completed on post-stroke patients are best monitored with a. fMRI b. PET c. SPECT d. TMS TRUE AND FALSE QUESTIONS 1. Research has suggested that the network of neural structures involved in motor control functions similarly in people who stutter and those who do not stutter.

A) TRUE

B) FALSE

2. Brain imaging has been used to identify patients with possible PD before clinical symptoms have appeared.

A) TRUE

B) FALSE

3. During periods of dysfluency people who stutter often fail to activate Wernicke’s area.

A) TRUE

B) FALSE

4. PET has been useful in determining appropriate drug therapy for patients with multiple sclerosis.

A) TRUE

B) FALSE

5. The P300 potential is a noninvasive method of evaluating cognitive function in patients with AD. A) TRUE

B) FALSE

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6. fMRI has been used to diagnose tumors, cerebrovascular disease, head trauma and cerebral atrophy.

A) TRUE

B) FALSE

7. PET and SPECT are the preferred techniques to detect loss of neurotransmitter function in patients with PD. A) TRUE

B) FALSE

8. MRI offers a high degree of spatial resolution and can be used to observe both healthy and disordered brain structures.

A) TRUE

B) FALSE

9. One of the primary disadvantages of TMS is possible health risks due to radiation levels.

A) TRUE

B) FALSE

10. On a PET scan, activity levels in different parts of the brain are represented by colors ranging from red to purple.

A) TRUE

B) FALSE SHORT ANSWER QUESTIONS

1. Discuss the advantages and disadvantages of CT and MRI. 2. Discuss the methodology used to elicit evoked potentials.

3. Identify the similarities and differences between PET and SPECT. 4. Discuss transcranial magnetic stimulation, including what it assesses and what other brain imaging techniques it could be used with.

5. Explain how the P300 potential may be used to assess cognitive function in individuals with PD and AD. ESSAY QUESTIONS 1. Discuss the research associated with stuttering, providing information on brain function in individuals who stutter compared to those who do not stutter.

2. Explain how MRI works and what type of information it provides.

3. Describe the benefits of using brain imaging techniques in patients with PD, MS, and AD.

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4. Discuss the concept of quantitative EEG, including its advantages and disadvantages. Explain the benefits of this technology in assessment and treatment of communication disorders.

5. Discuss how understanding brain structure and function has facilitated the effective diagnosis and evaluation of individuals with a variety of neurological disorders.

CHAPTER 13 MODELS AND THEORIES OF SPEECH PRODUCTION AND PERCEPTION CHAPTER OVERVIEW I. MODELS II. THEORIES III. SPEECH PRODUCTION • Spatial and Articulatory Target Models • Feedback and Feedforward Models • The DIVA Model • Action Theory IV. SPEECH PERCEPTION • Motor Theory

KEY CONCEPTS ACTION THEORY CONTRAST-DEFINING FEATURES COORDINATIVE STRUCTURES DEGREES OF FREEDOM DIVA MODEL FEEDBACK MODEL FEEDFORWARD MODEL GAMMA LOOP

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GESTURE MIRROR NEURONS MODEL MOTOR THEORY TARGET MODELS (ACOUSTIC) TARGET MODELS (SPATIAL) SPEECH PERCEPTION SPEECH PRODUCTION THEORY

EMPHASES AND INSTRUCTIONAL ACTIVITIES 1. Distinguish between a model and a theory. Ask students to provide examples of models and theories that may or may not be related to speech science.

2. Explain the concept of “degrees of freedom” in terms of speech production.

3. Discuss articulatory and auditory target models. Describe how both models can help to explain the segmental aspects of speech production based on contrast-defining features.

4. Elaborate on the concepts of feedback and feedforward, and introduce the concept of the gamma loop.

5. Connect the feedback and feedforward models to the DIVA model. Explain the relevance of the DIVA model in speech motor control.

6. Introduce Action theory and the idea of coordinative structures.

7. Review the concept of speech perception and the links between speech perception and speech production. Explain the Motor theory, and note how the current version of the theory differs from the older version. Discuss mirror neurons and how their discovery helps solidify the link between speech perception and production.

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CHAPTER THIRTEEN TEST BANK MULTIPLE CHOICE QUESTIONS 1. Which of the following statements best describes a model? a. A statement about a particular phenomenon, incorporating the underlying principles and assumptions. b. A simplification of a system that can be manipulated in a controlled manner. c. Explains observed data and can be used to make predictions about related events. d. Often used to institute changes in clinical practice.

2. A model a. May be mechanical, physiological, mathematical, or computer based. b. May be created to test a proposed theory about how a system functions. c. Can help to explain aspects of speech perception and production. d. All of the above 3. Which of the following statements (if any) are NOT true of theories? a. Theories may change based on incoming information and new research. b. Theories may be used to make predictions about events related to the phenomenon in question. c. Theories are often constructed to represent a system in some way that can be tested. d. All of the above statements are true of theories.

4. The concept of degrees of freedom relates to a. The speech motor system’s regulation of muscular contractions of all the speech subsystems. b. The possible link between speech perception and speech production. c. An internalized map of the vocal tract in the brain that allows the speaker to move his/her articulators to specific regions. d. None of the above.

5. The target model forms the basis for a framework that explains a. Speech motor regulation during speech production. b. Humans’ ability to inhale the appropriate amount of air for a given utterance. c. The segmental aspects of speech production. d. Movement of the articulators to planned regions within the oral cavity.

6. Which of the following statements is true about the gamma loop? a. Allows for rapid feedback. b. Gamma nerve fibers conduct nerve signals from muscles toward the spinal cord. c. Gamma nerve fibers synapse with alpha nerve fibers within the spinal cord d. All of the above.

7. The DIVA model helps to explain speech production breakdowns in all of the following EXCEPT a. Broca’s aphasia b. Amyotrophic lateral sclerosis 84

c. Postlingual deafness d. Stuttering 8. According to the Motor theory a. Speakers rely on the syllabic structure of speech to perceive meaningful information. b. Individuals perceive speech because they have experience producing speech sounds. c. Speakers focus on acoustic-phonetic features to supplement other linguistic information. d. All of the above.

9. Which of the following statements is NOT true about mirror neurons? a. They help to explain the link between speech perception and speech production. b. They match observed actions to corresponding areas of the observer’s motor cortex. c. They link groups of muscles to perform a particular task. d. They fire during execution and observation of actions.

10. Research showing that observing speech-related lip movements or listening to speech increases the excitability of motor units in the left hemisphere supports a. Action theory. b. Feedback and feedforward. c. Motor theory. d. The DIVA model.

TRUE AND FALSE QUESTIONS 1. According to the target model, targets may be auditory or spatial.

A) TRUE

B) FALSE

2. Contrast-defining features specify how the articulators are to be moved and what acoustic properties are to be achieved by these movements.

A) TRUE

B) FALSE

3. Action theory states that the motor cortex specifies movements of individual articulators.

A) TRUE

B) FALSE

4. Feedback and feedforward are essential elements of action theory.

A) TRUE

B) FALSE

5. Gamma nerves carry signals from muscles toward the spinal cord.

A) TRUE

B) FALSE

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6. According to a spatial target model, a series of spatial targets are specified in advance by the speaker’s nervous system.

A) TRUE

B) FALSE

7. According to acoustic-auditory models, the goal of speech production is the appropriate acoustic output, and the articulatory movements made to achieve the acoustic output can vary.

A) TRUE

B) FALSE

8. Theories are tested using models and attempt to explain speech perception and production.

A) TRUE

B) FALSE

9. Theories are simplifications of a system or any of the system’s parts.

A) TRUE

B) FALSE

10. A gesture, as defined in the motor theory, is a family of neuromotor commands that control and coordinate the activity of the articulators.

A) TRUE

B) FALSE SHORT ANSWER QUESTIONS

1. Explain the difference between a model and a theory.

2. Describe what is meant by “degrees of freedom” and explain how this notion relates to articulation.

3. What are contrast-defining features and which model are they associated with?

4. What is the gamma loop? In your response, include which model a gamma loop is associated with as well as a description of the anatomy relevant to the gamma loop.

5. Explain how the notion of coordinative structures relates to action theory.

ESSAY QUESTIONS 1. Explain the essential principles of the current version of motor theory and describe how the current version differs from previous versions.

2. Describe the DIVA model and relate the model to the concepts of feedback and feedforward.

3. Describe mirror neurons and explain how the discovery of these neurons has contributed to the development and support of specific theories of speech production and perception.

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4. Explain why speech perception is not based on a linear correspondence between acoustic speech signals and linguistic phonemic units.

5. Discuss how the current version of motor theory has been corroborated by brain imaging studies, and provide an example of one disorder that has been shown to be consistent with this theory.

SPEECH SCIENCE THIRD EDITION, TEST BANK ANSWER KEY CHAPTER 1 MULTIPLE CHOICE ANSWERS: 1. A 2. A 3. C 4. D 5. A 6. B 7. A 8. C 9. D 10. C

TRUE/FALSE ANSWERS: 1. TRUE 2. TRUE 3. FALSE 4. FALSE 5. TRUE 6. FALSE 7. TRUE 8. TRUE 9. TRUE 10. FALSE CHAPTER 2

MULTIPLE CHOICE ANSWERS: 1) D. 2) C. 3) D. 4) A. 5) C. 6) D. 7) B. 8) D. 9) A. 10. B

TRUE/FALSE ANSWERS: 1) TRUE 2) TRUE 3) FALSE 4) FALSE 5) TRUE 6) FALSE 7) TRUE 8) FALSE 9) TRUE 10) TRUE CHAPTER 3

MULTIPLE CHOICE ANSWERS: 1. A. 2. C. 3. A. 4. B.

5. D. 6. D. 7. B. 8. D. 9. D. 87

10. A.

5. TRUE 6. TRUE 7. FALSE 8. FALSE 9. TRUE 10. FALSE

TRUE/FALSE ANSWERS: 1. TRUE 2. FALSE 3. FALSE 4. TRUE

CHAPTER 4 MULTIPLE CHOICE ANSWERS: 1. C. 2. A. 3. D. 4. B. 5. C. 6. D. 7. D. 8. A. 9. B. 10. C.

TRUE/FALSE ANSWERS: 1. TRUE 2. FALSE 3. FALSE 4. TRUE 5. FALSE 6. TRUE 7. TRUE 8. TRUE 9. TRUE 10. FALSE

CHAPTER 5 MULTIPLE CHOICE ANSWERS: 1. A. 2. C. 3. D. 4. A. 5. D. 6. B. 7. A. 8. B. 9. D. 10. C.

TRUE/FALSE ANSWERS: 1. TRUE 2. FALSE 3. FALSE 4. TRUE 5. TRUE 6. FALSE 7. TRUE 8. TRUE 9. TRUE 10. TRUE CHAPTER 6

MULTIPLE CHOICE ANSWERS: 1. A. 2. A. 3. D. 4. B. 5. C.

6. D. 7. A. 8. C. 9. C. 10. B. 11. D. 88

TRUE/FALSE ANSWERS: 1. TRUE 2. TRUE 3. FALSE 4. TRUE 5. FALSE

6. TRUE 7. TRUE 8. FALSE 9. TRUE 10. FALSE

CHAPTER 7 MULTIPLE CHOICE ANSWERS: 1. B. 2. B. 3. A. 4. A. 5. C. 6. A. 7. B..

8. B. 9. B. 10. D.

TRUE/FALSE ANSWERS: 1. FALSE 2. TRUE 3. TRUE 4. FALSE 5. TRUE 6. FALSE 7. TRUE 8. FALSE 9. FALSE 10. TRUE CHAPTER 8

MULTIPLE CHOICE ANSWERS: 1. C. 2. A. 3. C. 4. B. 5. B. 6. A. 7. D. 8. B. 9. D. 10. D.

TRUE/FALSE ANSWERS: 1. TRUE 2. TRUE 3. TRUE 4. FALSE 5. TRUE 6. FALSE 7. FALSE 8. TRUE 9. FALSE 10. FALSE CHAPTER 9

MULTIPLE CHOICE ANSWERS: 1. D. 2. D. 3. A. 4. A. 5. A. 6. B.

7. D. 8. D. 9. C. 10. C. TRUE/FALSE ANSWERS: 1. FALSE 89

2. TRUE 3. FALSE 4. FALSE 5. TRUE 6. FALSE

7. TRUE 8. TRUE 9. TRUE 10. FALSE

CHAPTER 10 MULTIPLE CHOICE ANSWERS: 1. B. 2. C. 3. D. 4. D. 5. A. 6. D. 7. A. 8. A. 9. C. 10. B.

TRUE/FALSE ANSWERS: 1. TRUE 2. TRUE 3. TRUE 4. FALSE 5. TRUE 6. FALSE 7. FALSE 8. TRUE 9. TRUE 10. FALSE CHAPTER 11

MULTIPLE CHOICE ANSWERS: 1. D. 2. C. 3. D. 4. A. 5. D. 6. B. 7. A. 8. B. 9. D. 10. D. 11. C. 12. A. 13. D. 14. C. 15. D. 16. B. 17. B. 18. C. 19. A. 20. C.

TRUE/FALSE ANSWERS: 1. TRUE 2. TRUE 3. TRUE 4. FALSE 5. FALSE 6. TRUE 7. FALSE 8. TRUE 9. TRUE 10. FALSE 11. TRUE 12. FALSE 13. TRUE 14. TRUE 15. TRUE 16. TRUE 17. FALSE 18. TRUE 19. TRUE 20. FALSE

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CHAPTER 12 MULTIPLE CHOICE ANSWERS: 1. A. 2. C. 3. D. 4. B. 5. C. 6. A. 7. B. 8. D. 9. D. 10. B. 11. B. 12. A.

TRUE/FALSE ANSWERS: 1. FALSE 2. TRUE 3. TRUE 4. FALSE 5. TRUE 6. FALSE 7. TRUE 8. TRUE 9. FALSE 10. TRUE

CHAPTER 13 MULTIPLE CHOICE ANSWERS: 1. B. 2. D. 3. C. 4. A. 5. C. 6. D. 7. B. 8. B. 9. C. 10. C.

TRUE/FALSE ANSWERS: 1. FALSE 2. TRUE 3. FALSE 4. FALSE 5. TRUE 6. TRUE 7. TRUE 8. TRUE 9. FALSE 10. TRUE

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