3.02 - Dysarthria & Voice Flashcards
What are Dysarthrias?
A group of disorders that impair the ability to execute motor movement
Can Dysarthria co-occur with aphasia?
Yes
Is it Apraxia or Dysarthria?
Articulation is good for automatic speech.
Apraxia
Is it Apraxia or Dysarthria?
Errors are predictable and constant
Dysarthria
Is it Apraxia or Dysarthria?
There are visible groping postures
Apraxia
Is it Apraxia or Dysarthria?
Someone has difficulty initiating speech.
Apraxia
Is it Apraxia or Dysarthria?
There are deficits involving respiration, phonation, articulation, prosody, & resonance.
Dysarthria
Is it Apraxia or Dysarthria?
Someone has difficulty with imitation.
Apraxia
What is the goal for treating Dysarthrias?
To improve intelligibility & speech motor control
What are the classes of Dysarthria?
Flaccid
Spastic
Ataxic
Hypokinetic
Hyperkinetic
Mixed
Unilateral
What are the four techniques in treating Dysarthria?
Behavior Modification
Prosthetic Devices
Medical & Surgical Procedures (pharyngeal flap)
Augmentative/Alternative Devices
What are the subsystems of Dysarthria?
Respiratory
Phonatory
Resonance
Articulatory
Prosody
What is the goal of dealing with the Respiratory aspects of Dysarthria?
To establish consistent, controlled exhalation
What can be the issue with the Respiratory Aspects of Dysarthria?
Inefficient use of the breath stream in speech
What is the goal in dealing with the Phonatory Aspects of Dysarthria?
To establish efficient vocal fold closure during speech
What are the two issues that can occur in the Phonatory Aspects of Dysarthria?
Hyper Adduction
Hypo Adduction
Which has the biggest effect on speech: Hypoadduction or Hyperadduction?
Hypoadduction
What is the goal in dealing with the Resonance Aspects of Dysarthria?
To decrease hypernasality by generating appropriate intraoral pressure
What are the two issues that can occur in the Resonance Aspects of Dysarthria?
Hypernasality
Nasal Air Emission
What is the goal in dealing with the Articulatory Aspects of Dysarthria?
Improving speech sound production within the constraints of the client’s impairment
What are the issues that can occur in the Articulatory Aspects of Dysarthria?
The pattern of articulatory errors varies
What is the goal in dealing with the Prosody Aspects of Dysarthria?
To improve intelligibility by focussing on the specific prosodic difficulties
What are the issues that can occur in the Prosody Aspects of Dysarthria?
(6)
Monopitch
Monoloudness
Excessive or equal stress on words
Inappropriate intonation
Inappropriate rate
Etc.
What is the goal in the treatment of Apraxia?
Increasing voluntary control over the articulatory movements
How is Apraxia usually treated?
By using drills
Practicing motor movements over and over again.
What can also be used to help with Apraxic Speech?
AAC devices
What is usually the issue with voice disorders?
2
Trouble initiating or controlling the voice
Trouble with pitch, loudness, and/or quality
What does the client need to do before beginning therapy for voice disorders?
See an ENT to rule out pathologies
What is Dysphonia?
Any condition where there is a poor or unpleasant voice quality
What are nonorganic factors that can lead to disphonia?
4
Aphonia
Stress
Anxiety
Emotional problems
What are organic factors that can lead to Disphonia?
5
Laryngitis
Tumors
Paralysis
Vocal Fold Webbing
Etc.
What is an Organic Voice issue?
One caused by a pathology affecting the larynx or the vocal folds
Usually alters the mass of the vocal folds
What is a Functional Voice issue?
One cause by vocal abuse or psychological factors
What are symptoms of Functional Voice issues?
5
Whispered voice
Breathy voice
Hoarse voice
Tight voice
Variation in pitch and/or loudness
What are the three kinds of intervention for voice disorders?
Medical
Environmental
Behavioral
What are medical interventions of voice disorders?
One performed by an ENT or medical doctor
What are environmental interventions of voice disorders
Modifying the client’s surroundings to adjust to vocal demands
What are behavioral interventions of voice disorders?
Modifying specific symptoms (hoarseness, breathiness, etc.)
What is Edema?
2
Tissue swelling due to excess fluid
Can be a symptom of a larger disease
What are some etiologies of Edema?
5
Vocal misuse
Localized diseases
Allergies
Smoking
Endocrine inbalance (thyroid issues, menstral, pregnancy, etc.)
What is Infectious Laryngitis?
Laryngitis caused by a virus or bacterial infection
What are some symptoms of Infectious Laryngitis?
5
Fever
Headache
Runny nose
Sore throat
Coughing
How do you treat Infectious Laryngitis?
3
Voice rest
Fluids
Pain reliever
What is Gastroesophageal Reflux (GERD)?
2
Acid from the stomach that comes up through the lower esophageal sphincter
It can burn the pharyngeal & laryngeal structures
How can Gastroesophageal Reflux (GERD) be diagnosed?
2
pH monitoring
Endoscopy
What are Polyps?
Benign lesions
Do polyps tend to be bilateral or unilateral?
Unilateral
What are the two types of laryngeal polyps?
Sessile (broad based)
Pedunculated (attached via a stalk)
What is a symptom of polyps?
3
Breathiness
Hoarseness
Rough voice
What are Nodules?
A type of polyp
Are nodules usually bilateral or unilateral?
Bilateral
What are two other names for vocal nodules?
Singer’s nodes
Screamers nodes
What is Papilloma?
2
A benign neoplasm (abnormal growth) with a a core of vascular connective tissue
Looks like multiple clusters of warts
Where do papillomas tend to form?
On the vocal folds but they can invade the trachea
What is the etiology of papilloma?
Virus with some hormonal link (more common in prepubescent males)
What is the treatment for papilloma?
Surgery
What is Vocal Webbing?
A congenital or acquired disorder
How is Vocal Webbing treated?
By surgery
What does Vocal Fold Paralysis affect?
Vocal quality & airway competency
What is Spasmodic Dysphonia?
Involuntary movement (spasms) of the vocal folds
How do you treat Spasmodic Dysphonia?
Medically & behaviorally
What are Psychogenic Voice Disorders?
Those caused by issues not involving the larynx (anxiety, etc.)
What are the two major Psychogenic Voice Disorders?
Conversion Dysphonia
Mutational falsetto
What is Conversation Dysphonia?
Dysphonia (mild hoarseness) ->
Aphonia ->
Mutism
What is Falsetto?
2
Speaking with a pitch too high for one’s vocal tract
Can occur from an incomplete closure of the vocal folds
What are three other names for Falsetto?
Puberphonia
Mutational falsetto
Incomplete maturation of voice
What is Paradoxical Vocal Fold Movement?
2
The vocal folds should abduct before inhalation and slightly adduct during exhalation
This is when the opposite occurs
Paradoxical Vocal Fold Movement usually occurs in ______. The person can sound like they are ________.
Adolescents
Out of breath
What are the three parts to a vocal assessment?
Listening (obtaining a good speech sample)
Objective measurements (voice measurements and airflow measurements)
Looking (Stroposcope)
What are the two parts to a Quick Screen for Voice?
Listen and rate
Tasks to judge
What is the “Listen & Rate” Portion of the Quick Screen for Voice?
(3)
Respiration
Phonation
Resonance
What is the “Tasks to Judge” Portion of the Quick Screen for Voice?
(4)
Habitual Pitch
Loudness
Maximum phonation time
Pitch range
What 8 things are looked for in a Stroboscopic Assessment?
Arytenoid approximation
Vocal fold approximation
Vocal fold edge
Vocal fold surface
Mucous
Vibratory behavior
Amplitude
Mucosal wave function
What are the three stages of Voice Treatment Therapy?
Primary (prevention)
Secondary (early dectection)
Tertiary (remediation)
What are the two Behavioral Techniques for Voice Treatment?
Vocal Hyperfuntion
Vocal Hypofuntion
What do we work on when treating Vocal Hyperfuntion?
5
Relaxation
Reducing loudness
Softening glottal attacks
Pitch adjustment
Inhalation phonation (as a relaxer)
What do we work on when treating Vocal Hypofuntion?
2
Pushing/pulling glottal closure
Increasing loudness (respiratory pattern)
What can be used to assist in Alaryngeal Speech?
Using vibration that does not come from larynx (like false vocal folds)
Using mechanical devices
