childhood aos
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neurological communicative
neurological communicative
neurological communicative
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childhood aos
In adults, apraxia of speech is associated with various kinds of neuropathological factors that have been well documented. However, children also may have apraxia, including apraxia of speech. Childhood apraxia of speech was also known as developmental apraxia of speech, but childhood apraxia of speech is now the preferred term. Although most clinicians agree that childhood apraxia of speech exists, more research is needed to fully understand all of its symptoms, the associated clinical conditions, and their causes. Childhood apraxia of speech may be diagnosed in three groups of children. The first group of children with childhood apraxia of speech has a history of known neurological problems that include sustained head injury, brain infections, and intrauterine strokes. The second group of children with childhood apraxia of speech has complex neurobehavioral disorders such as autism or epilepsy and certain genetic syndromes, such as Down Syndrome. Finally, the third group of children that may exhibit childhood apraxia of speech has no known neurological or neurobehavioral impairments, but their speech symptoms may resemble those that are associated with such impairments. Childhood apraxia of speech in this last group may be considered idiopathic, in the sense that the causes are unknown. When its origin is idiopathic, the concept of childhood apraxia of speech is controversial because the term idiopathic implies an absence of neurological injury or diseases that cause apraxia of speech. A general clumsiness or motor incoordination may be found in some children with childhood apraxia of speech, but this may not be a good justification for the diagnosis because of the absence of gross brain pathology that is evident in adults with apraxia of speech. A genetic influence is suspected because the disorder seems to run in some families, and more boys than girls exhibit the disorder. However, no specific related gene has been isolated. Furthermore, clinicians do not agree on the symptoms or characteristics that are essential to diagnose childhood apraxia of speech, and there is no reliable list of symptoms that distinguish if from other speech sound disorders. Regardless of its origin, childhood apraxia of speech is defined as a disturbance in the precision and consistency of speech movements even though there are no such neuromuscular deficits as muscle weakness, abnormal reflexes, or increased muscle tone. Speech problems seen in children with childhood apraxia of speech are thought to be due to impairment in planning and executing the sequenced movements of articulators necessary to produce speech sounds. Delayed speech acquisition may be one of the early signs of childhood apraxia of speech. When they begin to speak, children with childhood apraxia of speech tend to show numerous errors of speech sound production. Consequently, speech may be less intelligible. Consonant clusters are especially difficult for children with childhood apraxia of speech. They omit one or more sounds in a cluster. Fricatives, affricates, stops, and nasals also may be misarticulated. The children may substitute, omit, or distort speech sounds. Children with childhood apraxia of speech may exhibit several atypical errors and unusual sound sequences noted less frequently in children with other speech sound disorders. For instance, children with childhood apraxia of speech may add extraneous sounds, prolong or repeat speech sounds, and reverse sounds in words. The speech of children with childhood apraxia of speech may sound monotonous, lacking in normal rhythm and intonation. Stress may be placed on wrong syllables. An increased frequency of dysfluencies also characterizes childhood apraxia of speech.
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