SLPLE cheat sheet

Language has five components: phonology (sound system), morphology (word structure), syntax (sentence structure), semantics (meaning), and pragmatics (social use).

Speech production requires respiration (breath support), phonation (vocal fold vibration), resonation (oral/nasal balance), and articulation (movement of lips, tongue, jaw, palate).

Typical speech sound acquisition: vowels and early consonants (/p, b, m, n, w/) by age 3; later sounds (/s, z, l, r, θ, ð, ʒ, tʃ, dʒ/) mastered by ages 6–8.

Brown's 14 grammatical morphemes emerge in a predictable order; Stage I (MLU 1.0–2.0) includes present progressive -ing, in, on, and regular plural -s.

Piaget's stages: sensorimotor (0–2), preoperational (2–7), concrete operational (7–11), formal operational (11+); object permanence develops in sensorimotor stage.

Joint attention (shared focus between child and caregiver on an object) emerges around 9–12 months and predicts later vocabulary size.

By 12 months, infants typically have 1–3 words; by 24 months, ~50–300 words and two-word combinations; by 36 months, ~1000 words and simple sentences.

The International Classification of Functioning, Disability and Health (ICF) framework considers body functions/structures, activities, participation, environmental and personal factors.

Speech sound disorder classification: articulation (phonetic, motor-based) vs. phonological (phonemic, rule-based); phonological processes include fronting, stopping, gliding, final consonant deletion, cluster reduction.

Developmental apraxia of speech (DAS) features: inconsistent errors, groping, difficulty with volitional oral movements, and prosodic abnormalities; often requires motor-based intervention.

Developmental language disorder (DLD) is diagnosed when language difficulties persist without a known biomedical cause and impact daily functioning; receptive and/or expressive language may be affected.

Stuttering is characterized by core behaviors (repetitions, prolongations, blocks) and secondary behaviors (escape/avoidance); onset typically 2–5 years, with a higher recovery rate when family history is absent.

Risk factors for persistent stuttering: family history, male sex, late onset (after 3.5 years), and coexistence of other speech/language disorders.

Voice disorders in children include vocal fold nodules (often from vocal abuse), vocal fold paralysis, and papilloma; dysphonia is persistent hoarseness or altered voice quality.

Language disorder vs. speech disorder: speech refers to sound production; language refers to understanding and use of words and sentences; a child can have one without the other.

Early intervention for language delay often uses parent-implemented naturalistic strategies (e.g., focused stimulation, milieu teaching) to increase language-facilitating interactions.

Aphasia types: Broca's (nonfluent, impaired repetition, comprehension relatively preserved), Wernicke's (fluent, poor comprehension, impaired repetition), conduction (fluent, good comprehension, impaired repetition), global (nonfluent, poor comprehension, impaired repetition).

Right hemisphere damage (RHD) often causes aprosodia, neglect, and pragmatic deficits (e.g., difficulty with inference, humor, and discourse organization).

Dysarthria types: flaccid (lower motor neuron; hypernasality, breathiness), spastic (upper motor neuron; strained-strangled voice), ataxic (cerebellar; irregular articulatory breakdowns), hypokinetic (basal ganglia; reduced loudness, monotone), hyperkinetic (involuntary movements).

Apraxia of speech (AOS) is a motor planning/programming disorder with inconsistent errors, groping, and difficulty initiating speech; often co-occurs with aphasia.

Dysphagia warning signs: coughing/choking during meals, wet voice, pocketing, drooling, unexplained weight loss, recurrent pneumonia; instrumental assessment includes videofluoroscopic swallow study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES).

National Dysphagia Diet (NDD) levels: Level 1 dysphagia pureed, Level 2 mechanically altered, Level 3 advanced, Level 4 regular; liquids: thin, nectar-thick, honey-thick, spoon-thick.

Traumatic brain injury (TBI) cognitive-communication deficits include impaired attention, memory, executive function, and social communication; intervention often uses external aids and metacognitive strategies.

Dementia-related communication changes: anomia, reduced coherence, and later mutism; intervention focuses on compensatory strategies, environmental modification, and caregiver training.

Pure-tone audiometry determines hearing thresholds in dB HL; normal adult threshold is ≤25 dB HL; degrees of hearing loss: mild (26–40), moderate (41–55), moderately severe (56–70), severe (71–90), profound (>90).

Air-bone gap indicates conductive component; sensorineural loss shows no gap (air and bone thresholds within 10 dB).

Tympanometry types: Type A (normal), Type B (flat, e.g., effusion or perforation), Type C (negative pressure, eustachian tube dysfunction).

Otoacoustic emissions (OAEs) assess cochlear outer hair cell function; absent OAEs suggest sensorineural loss >25–30 dB HL.

Auditory brainstem response (ABR) estimates hearing thresholds and assesses retrocochlear integrity; used for newborn screening and difficult-to-test populations.

Speech recognition testing (e.g., WRS, SRT) quantifies functional hearing; rollover phenomenon (performance decreases at high presentation levels) suggests retrocochlear pathology.

Hearing aid fitting: prescriptive targets (e.g., NAL-NL2), real-ear measurement, and verification; cochlear implants are indicated for severe-to-profound sensorineural loss with limited benefit from amplification.

Aural rehabilitation includes auditory training, speechreading, communication strategies, and counseling; it aims to reduce activity limitations and participation restrictions.

Assessment should be comprehensive, culturally and linguistically appropriate, and include case history, standardized testing, nonstandardized measures, and dynamic assessment.

Standardized test scores: standard scores (mean 100, SD 15), percentile ranks, and confidence intervals; a score ≤1.5 SD below the mean often indicates impairment.

Dynamic assessment evaluates a child's learning potential (test-teach-retest) and reduces cultural/linguistic bias.

Differential diagnosis requires ruling out alternative explanations (e.g., hearing loss, intellectual disability, autism spectrum disorder, neurological conditions).

Diagnostic accuracy: sensitivity (true positive rate), specificity (true negative rate), positive predictive value, and negative predictive value; base rates affect predictive values.

Evidence-based practice (EBP) integrates best available research, clinical expertise, and client values/preferences; ASHA's EBP framework includes asking, acquiring, appraising, applying, and assessing.

ICD-10 and DSM-5 diagnostic criteria inform classification; in the Philippines, the Philippine Professional Standards for Speech-Language Pathologists guide practice.

Clinical decision-making should consider the WHO ICF framework, client-centered goals, and contextual factors (family, school, community).

Intervention approaches: behavioral (e.g., operant conditioning), developmental/constructivist, social-interactionist, and cognitive-based; selection depends on the disorder and client needs.

Speech sound intervention: traditional articulation therapy (isolation → syllable → word → phrase → sentence → conversation), phonological contrast therapy (minimal pairs), and motor-based approaches (PROMPT, DTTC).

Language intervention: focused stimulation, milieu teaching, joint action routines, and narrative-based intervention; for school-age children, curriculum-based strategies.

Fluency intervention: Lidcombe Program (operant, parent-delivered) for young children; fluency shaping (e.g., prolonged speech) and stuttering modification (e.g., cancellation, pull-out) for older clients.

Voice therapy: vocal hygiene, resonant voice therapy, Lee Silverman Voice Treatment (LSVT) for Parkinson's disease; goal is efficient, healthy phonation.

Aphasia intervention: constraint-induced language therapy (CILT), melodic intonation therapy (MIT) for nonfluent aphasia, and semantic feature analysis for anomia.

Dysphagia management: compensatory strategies (postural changes, swallow maneuvers) and rehabilitative exercises (e.g., Mendelsohn maneuver, Shaker exercise); diet texture modification per NDD.

Evidence-based practice requires critical appraisal of research (e.g., levels of evidence, systematic reviews, randomized controlled trials) and integration with client values.

ASHA Code of Ethics: four principles (beneficence, nonmaleficence, autonomy, justice) and specific rules; applies to members and certificate holders.

Philippine regulation: Republic Act No. 11249 (Philippine Speech-Language Pathology Act) regulates the practice of speech-language pathology; the Professional Regulation Commission (PRC) administers licensure.

Scope of practice: speech-language pathologists assess, diagnose, treat, and prevent communication and swallowing disorders; they do not practice medicine or audiology beyond their scope.

Informed consent: clients must receive information about assessment, treatment, risks, benefits, and alternatives; consent must be voluntary and documented.

Confidentiality: protected health information must be safeguarded; exceptions include suspected abuse, danger to self/others, and legal requirements.

Cultural competence: clinicians should provide services that respect cultural and linguistic diversity, use interpreters appropriately, and avoid bias in assessment.

Supervision and delegation: SLPs may supervise speech-language pathology assistants (SLPAs) and students according to jurisdictional regulations; the SLP retains responsibility for client care.

Continuing professional development (CPD): required for license renewal in the Philippines; ASHA requires 30 certification maintenance hours (CMHs) per 3-year cycle.