- Big Nine
- ASHA's nine areas of clinical service competence: speech sound production, fluency, voice and resonance, language, social communication, cognition, AAC, hearing, and feeding/swallowing.
- Scope of practice (SLP)
- The range of professional activities ASHA defines for an SLP — assessment, intervention, counseling, and prevention across the lifespan.
- CCC-SLP
- Certificate of Clinical Competence in Speech-Language Pathology — ASHA's national credential requiring a master's degree, Clinical Fellowship, and a passing Praxis 5331 score (162).
- Clinical Fellowship (CF)
- A mentored post-graduate period of at least 36 weeks / 1,260 hours required before the CCC-SLP is awarded.
- ASHA Code of Ethics
- ASHA's binding rules of professional conduct, built on principles of welfare of persons served, competence, integrity in public statements, and responsibility to the profession.
- Evidence-based practice (EBP)
- Clinical decisions that integrate the best external research evidence, clinician expertise, and the client's values and preferences.
- Difference vs. disorder
- A communication difference is a typical variation for a client's language or dialect (not pathology); a disorder is impaired relative to one's own community.
- Form, content, and use
- The three components of language: form (syntax, morphology, phonology), content (semantics/meaning), and use (pragmatics).
- Pragmatics
- The social use of language — turn-taking, topic maintenance, eye contact, and adjusting language to the listener and situation.
- Phonology
- The rule-governed sound system of a language — how sounds pattern and combine — distinct from the motor act of articulation.
- Morphology
- The study of morphemes, the smallest units of meaning (e.g., plural -s, past-tense -ed, prefixes and suffixes).
- Semantics
- The meaning of words and sentences — vocabulary, word relationships, and figurative language.
- Syntax
- The rules for ordering and combining words into grammatical phrases and sentences.
- Joint attention
- Sharing focus on an object or event with another person — an early social-communication milestone foundational to language.
- Mean length of utterance (MLU)
- The average number of morphemes per utterance in a language sample — an index of expressive language development.
- Cognitive aspects of communication
- The big-nine area covering attention, memory, problem solving, and executive function — most associated with TBI and dementia.
- Welfare of persons served
- The central ethical duty to hold the client's welfare paramount and provide services without discrimination.
- Practicing within competence
- An ethics rule: a task may be IN the SLP scope (e.g., dysphagia) yet still require training, mentoring, and supervised experience before independent practice.
- Accurate representation of credentials
- An ethics rule: never claim a credential (like CCC-SLP) you don't yet hold; a clinical fellow may not use CCC-SLP until ASHA awards it.
- Supervisory responsibility
- When tasks are delegated to an SLP assistant, the supervising certified SLP retains responsibility for the client's welfare.
- Confidentiality (records release)
- Protected client information is released only with appropriate authorization or a legitimate professional need.
- Conflict of interest
- An arrangement (e.g., a kickback for steering clients to a product) that could compromise client-centered judgment; the Code requires avoiding it.
- IDEA
- Individuals with Disabilities Education Act — the federal law governing special-education services, including school-based SLP services and IEPs.
- HIPAA vs. FERPA
- HIPAA protects health information (clinical settings); FERPA protects education records (school settings). Both govern client privacy.
- Cultural responsiveness
- Adapting assessment and intervention to a client's language and culture, and distinguishing a difference from a disorder.
- Counseling (SLP scope)
- Educating and supporting clients/families about the nature and management of a communication or swallowing disorder — within scope; psychotherapy is not.
- Validity
- Whether an assessment measures what it claims to measure.
- Reliability
- Whether an assessment yields consistent results across time, items, or raters.
- Wellness and prevention
- An SLP role: promoting communication/swallowing health and preventing disorders (e.g., vocal hygiene education, hearing conservation).
- Interprofessional collaboration
- Working as a team with families, teachers, physicians, and other providers to coordinate client care.
- Screening
- A quick pass/refer check to decide whether a full evaluation is warranted — it does NOT diagnose.
- Case history
- The background information (medical, developmental, educational, family) gathered at the start of an evaluation to guide assessment.
- Norm-referenced (standardized) test
- An assessment that compares a client to a normative sample (percentiles, standard scores) to identify whether a disorder exists.
- Criterion-referenced assessment
- An assessment measuring performance against a defined skill/criterion to identify what specifically to target in therapy.
- Dynamic assessment
- A test–teach–retest approach measuring how well a client learns with support; reduces cultural/linguistic bias.
- Language sample
- A recording of spontaneous, real language use analyzed for structures, MLU, and pragmatics.
- Standard score
- A score expressing a client's performance relative to the mean of a norm group (commonly mean 100, SD 15).
- Articulation disorder
- Difficulty physically producing individual speech sounds — motor-based errors such as a distorted /r/ or /s/.
- Phonological disorder
- A rule-based speech sound disorder in which whole classes of sounds are simplified by predictable error patterns.
- Fronting
- A phonological process in which back sounds (velars) are replaced by front sounds, e.g., 'key' → 'tea'. Typically resolves by ~3½ years.
- Stopping
- A phonological process in which fricatives/affricates become stops, e.g., 'sun' → 'tun'.
- Cluster reduction
- A phonological process in which a consonant cluster loses a sound, e.g., 'spot' → 'pot'. Typically resolves by ~4 years.
- Final consonant deletion
- A phonological process in which the ending consonant is omitted, e.g., 'cat' → 'ca'.
- Gliding
- A phonological process in which liquids (/l/, /r/) become glides (/w/, /j/), e.g., 'rabbit' → 'wabbit'.
- Stimulability
- The degree to which a client can correctly produce a target sound when given a model and cues; a prognostic indicator.
- Aphasia
- An acquired language disorder, usually from a left-hemisphere stroke, affecting speaking, understanding, reading, and/or writing.
- Broca's aphasia
- A nonfluent (expressive) aphasia: effortful, telegraphic speech with relatively preserved comprehension and good awareness; poor repetition.
- Wernicke's aphasia
- A fluent (receptive) aphasia: well-articulated but meaningless speech with paraphasias/neologisms, poor comprehension, and poor awareness.
- Conduction aphasia
- A fluent aphasia with good comprehension but disproportionately poor repetition, classically from arcuate fasciculus damage.
- Global aphasia
- A severe aphasia impairing all language modalities — nonfluent output, poor comprehension, and poor repetition — from a large left-hemisphere lesion.
- Anomic aphasia
- A fluent aphasia with intact comprehension and repetition but prominent word-finding difficulty and circumlocution.
- Transcortical motor aphasia
- A nonfluent aphasia with strikingly preserved repetition and relatively intact comprehension.
- Paraphasia
- A word or sound substitution error in aphasia; semantic (related word) or phonemic/literal (sound substitution).
- Neologism
- A nonword or made-up word produced in fluent aphasia (e.g., Wernicke's).
- Fluency vs. nonfluency (aphasia)
- The single feature that most reliably separates aphasia types — the flow, phrase length, and grammatical structure of speech output.
- Dysarthria
- A motor speech disorder of execution caused by muscle weakness or abnormal tone, producing slurred, imprecise, and CONSISTENT errors.
- Apraxia of speech
- A motor speech disorder of planning/programming with no weakness — INCONSISTENT errors, articulatory groping, and trouble sequencing sounds.
- Childhood apraxia of speech (CAS)
- A pediatric motor planning disorder: inconsistent productions of the same word, impaired volitional sequencing, and disrupted prosody, without weakness.
- Dysarthria vs. apraxia (tell)
- Dysarthric errors are CONSISTENT (weakness); apraxic errors are INCONSISTENT with groping (a planning problem).
- Oral mechanism exam
- A structural and functional check of lips, tongue, palate, and cranial nerves that support speech and swallowing.
- Cranial nerve X (vagus)
- Innervates the soft palate and pharynx; asymmetric palate elevation on 'ah' signals damage. Key for voice and swallowing.
- Cranial nerve XII (hypoglossal)
- Provides motor innervation to the tongue; protrusion deviates TOWARD the weak side, often with atrophy.
- Cranial nerve VII (facial)
- Innervates facial muscles for lip movements important to speech (e.g., bilabial sounds) and the oral phase of swallowing.
- Vocal nodules
- Benign, bilateral, callous-like lesions on the vocal folds from chronic vocal misuse/abuse; treated with voice therapy first.
- Vocal polyp
- A usually unilateral, fluid-filled vocal fold lesion, often from a single traumatic vocal event or irritation.
- Vocal fold paralysis
- Loss of vocal fold movement, often from CN X / recurrent laryngeal nerve injury; causes breathiness and possible aspiration.
- Hypernasality
- Excessive nasal resonance, suggesting velopharyngeal insufficiency (e.g., cleft palate).
- Hyponasality
- Reduced nasal resonance, suggesting nasal blockage or congestion.
- Stuttering
- A fluency disorder marked by repetitions, prolongations, and blocks that disrupt the forward flow of speech.
- Cluttering
- A fluency disorder of rapid and/or irregular rate with reduced intelligibility — distinct from stuttering.
- Conductive hearing loss
- Hearing loss from an outer- or middle-ear problem (e.g., otitis media, cerumen) blocking sound conduction.
- Sensorineural hearing loss
- Hearing loss from cochlear (hair cell) or auditory nerve damage; generally permanent.
- Audiogram (right vs. left)
- A graph of hearing thresholds by frequency; right-ear air conduction = red circles (O), left-ear = blue X's.
- Tympanometry
- An objective measure of middle-ear function (eardrum mobility) that helps identify conductive problems like fluid.
- Dysphagia
- A swallowing disorder affecting the oral, pharyngeal, and/or esophageal phases, carrying a risk of aspiration.
- Oral phase (swallow)
- The voluntary first phase: the bolus is chewed, formed, and propelled back by the tongue toward the pharynx.
- Pharyngeal phase (swallow)
- The reflexive phase: the swallow triggers, the larynx elevates and the airway closes, and the bolus passes the pharynx. Highest aspiration risk.
- Esophageal phase (swallow)
- The involuntary phase: peristalsis carries the bolus through the upper esophageal sphincter to the stomach.
- Aspiration
- Entry of food, liquid, or saliva below the level of the vocal folds into the airway.
- Silent aspiration
- Aspiration without a cough or overt sign; cannot be confirmed at bedside, so it requires an instrumental study.
- MBSS (modified barium swallow)
- A fluoroscopic instrumental study visualizing all swallow phases — the standard for confirming aspiration and physiology.
- FEES
- Fiberoptic endoscopic evaluation of swallowing — a nasendoscopic view of the pharyngeal swallow; portable and radiation-free.
- Valleculae and pyriform sinuses
- Pharyngeal spaces where residue collects when the swallow is impaired; pooling there signals a pharyngeal-phase problem.
- Etiology categories
- Sources of communication/swallowing disorders: genetic, developmental, disease/neurological, structural/functional, and psychogenic.
- Differential diagnosis
- Distinguishing among possible conditions that could explain a presentation to reach the correct diagnosis.
- Traumatic brain injury (TBI)
- An acquired injury commonly producing cognitive-communication deficits — attention, memory, and executive-function impairments.
- Right hemisphere disorder
- Communication deficits from right-brain damage — often pragmatics, prosody, attention, and inference, with relatively intact basic language.
- Dementia (communication)
- A progressive cognitive decline affecting memory and communication; SLP focuses on supportive, functional strategies.
- Measurable goal
- A goal stating an observable behavior, the condition, and a criterion for mastery, so progress can be judged objectively.
- Behavior, condition, criterion
- The three required parts of a measurable goal — what the client does, under what circumstances, and to what level of mastery.
- Long-term vs. short-term goal
- A long-term goal is the broad target; short-term objectives are incremental, measurable steps that build toward it.
- Functional goal
- A goal that is meaningful to the client's daily participation (e.g., 'order food independently'), not just clinic accuracy.
- Prognosis
- The clinician's prediction of the expected degree and rate of improvement — distinct from the diagnosis.
- Favorable prognostic indicators
- High motivation, awareness, family support, early intervention, and a single stable lesion improve a client's prognosis.
- Cycles approach
- A phonological treatment that targets error patterns in rotating cycles, using auditory bombardment and stimulable production words.
- Auditory bombardment
- A cycles step: brief, lightly amplified listening to words containing the target pattern at the start and end of each session.
- Minimal pairs
- A phonological treatment using word pairs that differ by one sound (e.g., 'key' vs. 'tea') to make the contrast meaningful.
- Maximal/multiple oppositions
- A phonological treatment contrasting sounds that differ by several distinctive features for broad, system-wide change.
- Traditional articulation therapy
- A sound-by-sound motor approach: establish the target sound, then generalize it across positions and contexts.
- Principles of motor learning
- Guidelines for motor speech treatment: many, meaningful, variable-practice repetitions that build self-monitoring and retention.
- PROMPT
- A motor speech approach using tactile-kinesthetic cues to guide articulator placement and movement, used for apraxia.
- Fluency shaping
- A stuttering treatment that replaces stuttered speech with new fluent patterns — easy onset, prolonged speech, light articulatory contact.
- Stuttering modification
- A Van Riper approach that makes moments of stuttering easier (cancellations, pull-outs, preparatory sets) and reduces fear and avoidance.
- Easy onset
- A fluency-shaping technique of gently beginning voicing with relaxed vocal fold onset to reduce hard glottal attacks.
- Cancellation
- A stuttering-modification technique: pause after a stuttered word, then re-produce it more easily.
- Pull-out
- A stuttering-modification technique of easing out of a stutter while it is happening, smoothing the moment.
- Preparatory set
- A stuttering-modification technique of entering a feared word with an easier, planned approach before the stutter occurs.
- Integrated fluency approach
- Blending fluency shaping (smoother speech) with stuttering modification (managing feelings and avoidance).
- Indirect fluency treatment
- An approach for young children who stutter that coaches parents and modifies the communicative environment.
- Vocal hygiene
- Behavioral changes (hydration, reducing yelling/throat-clearing) that reduce vocal misuse — the first line for nodules.
- Resonant voice therapy
- A behavioral voice therapy promoting easy, forward-focused phonation to reduce strain and improve vocal quality.
- Semantic feature analysis
- An aphasia treatment that improves word retrieval by analyzing a target word's features (category, use, properties).
- Melodic intonation therapy
- An aphasia treatment using melody and rhythm to facilitate speech production, often in nonfluent (Broca's) aphasia.
- Naturalistic/milieu teaching
- A child-language approach embedding targets in child-led, meaningful play to promote spontaneous generalization.
- Focused stimulation
- A child-language technique providing many concentrated models of a target form in meaningful contexts.
- AAC
- Augmentative and alternative communication — aided or unaided supports that supplement or replace natural speech.
- Aided vs. unaided AAC
- Unaided AAC uses only the body (gestures, manual signs); aided AAC uses an external tool (picture boards, speech-generating devices).
- Feature matching
- The AAC process of aligning a system's features with the client's abilities, needs, and environment.
- Core vocabulary
- A small set of high-frequency words (want, go, more, stop) usable across many contexts — prioritized in AAC.
- Fringe vocabulary
- Context- or topic-specific words in an AAC system (names, favorite items) that supplement core vocabulary.
- Aided language stimulation
- Modeling AAC use by pointing to symbols on the client's system while speaking, within natural communication.
- Speech-generating device (SGD)
- A high-tech AAC device that produces spoken output; a dynamic display lets vocabulary pages change on screen.
- Compensatory swallow strategy
- A technique that makes a single swallow safer right now (e.g., chin tuck, diet modification) without changing physiology.
- Rehabilitative swallow strategy
- An exercise that strengthens muscles and changes swallow physiology over time (e.g., effortful swallow, Shaker exercise).
- Chin tuck
- A compensatory swallowing posture that narrows the airway entrance and widens the valleculae to reduce aspiration.
- Mendelsohn maneuver
- A swallowing technique that prolongs laryngeal elevation to widen and sustain upper esophageal sphincter opening for better clearance.
- Effortful swallow
- A rehabilitative technique using a hard swallow to strengthen pharyngeal contraction and clear residue.
- Supraglottic swallow
- A technique of holding the breath to close the vocal folds before and during the swallow to protect the airway.
- Shaker (head-lift) exercise
- A rehabilitative exercise strengthening the suprahyoid muscles to improve upper esophageal sphincter opening.
- Diet/texture modification (IDDSI)
- A compensatory strategy thickening liquids or altering food texture; IDDSI provides standardized, testable diet terminology.
- Aural rehabilitation
- The SLP's role in hearing loss — auditory training, speechreading, communication strategies, and counseling to improve function.
- Speechreading (lipreading)
- Using lip movements, facial expression, and context to support understanding of speech in aural rehabilitation.
- Auditory training
- Structured listening practice progressing from sound detection to discrimination, identification, and comprehension.
- Communication partner training
- Teaching a client's everyday partners (aides, family) to pause, model, and support communication or AAC use.
- Progress monitoring
- Collecting session data and graphing it against the goal criterion to make data-based treatment decisions.
- Plateau response
- When progress data flatten despite consistent therapy, the clinician re-examines and modifies the target or approach.
- Generalization (carryover)
- Transfer of a learned skill to untrained words, partners, and settings beyond the therapy room.
- Maintenance
- Continued use of a learned skill after therapy ends, confirmed with follow-up checks.
- Discharge readiness
- The point at which goals are met AND the skill is generalized and maintained in the client's daily life.
- Task hierarchy
- Sequencing therapy targets from easier to harder (imitation → cued → spontaneous) to build success and independence.
- Cueing hierarchy
- A graded set of supports (from maximal to minimal cues) faded over time to increase the client's independence.
- Data-based decision making
- Adjusting treatment (advance, hold, or change the approach) based on collected progress data, not impression.
