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ECU Motor Speech Disorders > 3.1 - Motor Speech Exam > Flashcards

3.1 - Motor Speech Exam Flashcards

1
Q

Voice, speech and language undergo _______ and _______ change when people fall prey to certain organic and psychiatric illnesses. Such changes can be the ____________ early in its evolution.

A

Audible

Visible

First and only sign of a disease

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2
Q

The manner in which speech becomes defective logically reflects the ______ and _______ of the illness. A specialist trained in the analysis and interpretation of _____________ can contribute to medical diagnosis and selection of ensuing treatment.”

A

Pathophysiology

Psychodynamics

Abnormal communication

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3
Q

What is the purpose of a Motor Speech Exam?

7

A

Description of disorder

Establishing diagnostic possibilities

Establishing a diagnosis

Establishing implications for localization and disease diagnosis

Specifying severity

Developing a treatment plan

Developing a discharge plan

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4
Q

Why might we be called to assess patient’s in a psych ward?

A

Neurological issues can sometimes appear to be psychiatric issues due to the patient’s poor decision making, emotional level, and behavioral issues

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5
Q

What are the 3 General Exam Guidelines for Motor Speech Exams?

A

History (always take a good history)

Salient Features

Movement abnormalities/Confirmatory signs

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6
Q

What are the 6 Salient Features we look for in a Motor Speech Exam?

A

Strength

Speed

Range

Steadiness

Tone

Accuracy

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7
Q

What are the 4 Movement Abnormalities we look for in a Motor Speech Exam?

A

VOM: velocity/speed

ROM: range

DOM: direction

Accuracy

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8
Q

What are the 7 parts of a Clinical Motor Speech Exam?

A

History

Oral structures non-speech

Vowel prolongation

Alternating motor rates (AMR’s) diadochokinetic rates

Sequential motor rates (SMR’s)

Contextual speech

Stress testing

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9
Q

What are we looking for when we take a patient history during a Motor Speech Exam?

(8)

A

Introduction and goal setting

Basic data

Onset and course

Associated deficits

Patient’s perception of deficit

How patient perceives the consequences of the disorder

Previous management

Awareness of diagnosis and prognosis (does pt. understand why they are there)

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10
Q

What structures and movements do we exam during a Motor Speech Exam?

(7)

A

Face

Jaw

Tongue

Velopharynx

Larynx

Reflexes

Volitional vs Automatic Movements

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11
Q

What 9 General Items are we looking for in a Motor Speech Exam?

A

Facial Symmetry

Muscle Tone

Palsy (present/absent)

Raise Eyebrows

Frown

Vocal Quality

Volitional Cough

Throat Clear

Phonation Time (prolonged “ah”)

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12
Q

What 5 items in the Oral Cavity are we looking for in a Motor Speech Exam?

A

Dentition

Hygiene

Excess Secretions/Awareness of Drooling

Sensory Awareness

Debris (in mouth)

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13
Q

What 6 qualities of the Jaw are we looking for in a Motor Speech Exam?

A

Position at rest

Presence of Involuntary Movement

DDK

Range of opening and closure

Range of lateralization

Opening and closing with resistance

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14
Q

What 6 qualities of the Lips are we looking for in a Motor Speech Exam?

A

Position at rest

Smile

Frown

Ability to say /u/

Ability to alternate between /u/ and /i/

Puff cheeks and hold

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15
Q

If multiple areas are compromised in a Motor Speech Exam, the issue is probably ________.

A

Neurological

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16
Q

When performing a Motor Speech Exam, what do we want to look at on the Face?

(3)

A

Face at rest (symmetry, drooping, etc.)

Face during sustained posture (expressionless, expressions held too long, etc.)

Face during movement (abnormalities, extraneous movement, tremors, etc.)

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17
Q

When performing a Motor Speech Exam, what do we want to look at with the Jaw?

(3)

A

Jaw at rest (is it too low, etc.)

Jaw during sustained posture (involuntary movement, etc.)

Jaw during movement (deviations. resistance, etc.)

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18
Q

When performing a Motor Speech Exam, what do we want to look at with the Larynx?

A

Ability to cough

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19
Q

When performing a Motor Speech Exam, what do we want to look at with the Velopharynx?

(2)

A

At rest

During movement (symmetry, elevation, nasal airflow, resonance)

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20
Q

Which side of the Velopharynx will raise higher: the stronger side or the weaker side?

A

The stronger side

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21
Q

When performing a Motor Speech Exam, what do we want to look at with the Tongue?

(3)

A

Tongue at rest

Tongue during sustained postures

Tongue during movement (protrusion, deviations, resistance, etc.)

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22
Q

What are we generally looking at with Respiration during a Motor Speech Exam?

A

Only if there are issues that affect speech

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23
Q

What are we looking at with Reflexes during a Motor Speech Exam?

(2)

A

Confirmatory signs regarding localization of disease in CNS or PNS

Normal or pathologic reflexes

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24
Q

What Perceptual Assessment measures are we looking for during a Motor Speech Exam?

(1+8)

A

DAB Speech Dimensions (Mayo Clinic)

  • Respiration
  • Pitch
  • Loudness
  • Resonance
  • Voice quality
  • Articulation
  • Prosody
  • Other (motion rates, tics, palilalia)
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25
Q

What are we looking for when evaluating Pitch during a Motor Speech Exam?

A

Is it typical for pt.’s age + gender

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26
Q

What are we looking for when evaluating Loudness during a Motor Speech Exam?

A

Is it too soft?

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27
Q

What are we looking for when evaluating Voice Quality during a Motor Speech Exam?

(4)

A

Harshness (due to tension, nodules, etc.)

Breathiness (poor adduction)

Strained

Strangled

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28
Q

What are we looking for when evaluating Resonance during a Motor Speech Exam?

A

Is the pt. hypernasal or hyponasal?

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29
Q

What tasks might we ask a patient to perform for perceptual measures during a Motor Speech Exam?

(5)

A

Vowel prolongation

Alternating motor rates (AMR’s) diadochokinetic rates

Sequential motor rates (SMR’s)

Contextual speech

Stress testing

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30
Q

Do we normal ask patients to perform Vowel Prolongations if their voice sounds normal during a case history?

A

No

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31
Q

Why do we ask patients to perform Vowel Prolongations?

A

To isolate the respiratory-phonatory system used in speech

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32
Q

What speech dimensions are we looking for when we ask patients to perform Vowel Prolongations?

(3)

A

Pitch

Loudness

Voice Quality

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33
Q

What are median rates in seconds for Vowel Prolongations in Young Males?

A

28.5 seconds

34
Q

What are median rates in seconds for Vowel Prolongations in Young Females?

A

22.7 seconds

35
Q

What are median rates in seconds for Vowel Prolongations in Elderly Males?

A

13.8 seconds

36
Q

What are median rates in seconds for Vowel Prolongations in Elderly Females?

A

14.4 seconds

37
Q

What should we ask patients about voice quality?

A

Is quality or quantity more important?

38
Q

What are Alternating Motion Rates (AMR’s)?

A

Speed/regularity of reciprocal movements (jaw, lips, tongue)

39
Q

What are we looking for in Alternating Motion Rates (AMR’s)?

3

A

Articulatory precision

Adequacy of V-P closure

Respiratory/phonatory support

40
Q

What are median DDK rates (per sec.)?

3

A

/pʌ/ - 6.3

/tʌ/ = 6.2

/kʌ/ = 5.8

41
Q

What are we looking for in DDK rates?

A

Precision

42
Q

What are Sequential Motion Rates (SMR’s)?

A

Measure of sequential articulatory movements

43
Q

What are Sequential Motion Rates (SMR’s) important for?

A

Apraxia of Speech assessments

44
Q

What is the median rate for /pʌ tʌ kʌ/ in seconds?

A

5.0

45
Q

What changes in Sequential Motion Rates (SMR’s) as a patient’s disorder increases?

(2)

A

Apraxia increases

Ability to initiate decreases

46
Q

What is Contextual Speech?

A

Integration of all components of speech

47
Q

How do we assess Contextual Speech?

3

A

Conversational speech

Narrative discourse

Grandfather passage

48
Q

What are we looking for when assessing Speech Programming in a Motor Speech Exam?

(7)

A

Distorted articulation

Substitutions

Omissions

Repetitions

Additions

Articulatory postures

Groping

49
Q

What usually causes Distorted Articulation?

A

The tongue

50
Q

What sorts of Substitutions are seen in a Motor Speech Exam?

3

A

Sounds

Words

Gestures

51
Q

What is Groping a classic symptom of?

A

Apraxia

52
Q

Are Normative Tests often used to assess Dysarthria and Apraxia?

Why or why not? (2)

A

No

//

They take a lot of time

We can get the same information without a test

53
Q

What is a normative test used to assess Dysarthria?

A

Frenchay Dysarthria Assessment-2

54
Q

What is a normative test used to assess Apraxia?

A

Apraxia Battery for Adults – 2

55
Q

What is the Frenchay Dysarthria Assessment-2?

A

Test for the differential diagnosis of dysarthria types

56
Q

How many sections are in the Frenchay Dysarthria Assessment-2?

A

11 sections

57
Q

What 11 areas are assessed in the Frenchay Dysarthria Assessment-2?

A

Reflexes

Respiration

Lips

Jaw

Tongue

Palate

Larynx

Intelligibility

Rate

Sensation

Associated factors

58
Q

How long does it take to administer the Frenchay Dysarthria Assessment-2?

A

20+ minutes

59
Q

When might we use the Frenchay Dysarthria Assessment-2?

A

When we are confident that dysarthria is the only issue

60
Q

Why was the Apraxia Battery for Adults developed?

2

A

To verify the presence of apraxia in adults

To estimate the severity of the disorder

61
Q

What can scores on the Apraxia Battery for Adults do?

2

A

Describe patient performance over time

Quantify the diagnosis and severity

62
Q

How many subtests are on the Apraxia Battery for Adults?

A

6 subtests

63
Q

What are the 6 subtests on the Apraxia Battery for Adults?

A

Diadochokinetic rates (1,2, + 3 syllables)

Imitation of words of increasing length

Latency and utterance time for picture naming (multisyllabic words)

Repetition of polysyllabic words

Inventory of 15 based on spontaneous speech, reading, counting

Limb and oral apraxia test

64
Q

When is Apraxia of Speech harder to identify?

A

When it is masked by severe motor speech disorders or aphasia

65
Q

What are 3 crucial issues when assessing speech?

A

Intelligibility

Comprehensibility

Efficiency

66
Q

How do we assess Intelligibility?

A

Degree to which the listener/assessor understands the acoustic signal of the speaker

67
Q

How do we assess Comprehensibility?

A

Degree to which the listener/assessor understands the speaker on basis of acoustic signal and all other information contributing to understanding what is being said

68
Q

How doe we assess Efficiency?

A

Rate at which intelligible or comprehensible information is conveyed

69
Q

What are 4 Tests of Intelligibility?

A

Frenchay Dysarthria Assessment

Assessment of Intelligibility in Dysarthria Speech (AIDS)

Sentence Intelligibility Test

Word Intelligibility Test

70
Q

What 2 tests can be used for patients with severe unintelligibility to measure treatment progress?

A

Sentence Intelligibility Test

Word Intelligibility Test

71
Q

What does the Assessment of Intelligibility of Dysarthria Speech (AIDS) measure?

(5)

A

Measure of word and sentence intelligibility (Intelligibility Score)

Speaking Rate

Index of Severity

Rate of Intelligible Speech

Rate of Unintelligible Speech

72
Q

What are 2 Computerized Assessments of Intelligibility?

A

Computerized Assessment of Intelligibility of Dysarthric (CAIDS) -Computerized version of AIDS

Speech Intelligibility Test (SIT)

73
Q

What is the Computerized Assessment of Intelligibility of Dysarthria (CAIDS)?

A

Computerized version of AIDS

74
Q

What is the Speech Intelligibility Test (SIT)?

2

A

Computerized assessment

Combines features of AIDS, CAIDS, + Phoneme Intelligibility Test

75
Q

What two areas does the Speech Intelligibility Test (SIT) measure?

(2)

A

Sentences

Words

76
Q

What does the Speech Intelligibility Test (SIT) measure in Sentences?

(3)

A

Speech Intelligibility

Speaking Rate

Communication Efficiency

77
Q

What does the Speech Intelligibility Test (SIT) measure in Words?

(3)

A

Single word intelligibility

Percent of accurate vowels/consonants

Additional scoring for stops, fricatives, affricates, semi-vowels, nasals and pressure

78
Q

What are three additional tools we might use when assessing Motor Speech Disorders?

A

Communicative Effectiveness Survey

Dysarthria Impact Profile

Dysarthria Self-Report Questionnaire

79
Q

What is the Communicative Effectiveness Survey?

A

A questionnaire that asks patients to rate 8 statements about their speech on a spectrum of 1-4

80
Q

What can the Communicative Effectiveness Survey be useful for?

(2)

A

Evaluating the patient’s perspective

Evaluating the patient’s goals

81
Q

What is the Dysarthria Impact Profile?

A

A questionnaire that asks a patient to consider how dysarthria affects their everyday life

82
Q

What is the Dysarthria Self-Report Questionnaire?

A

A very long questionnaire that asks patients to rate each statement with definitely false, mostly false, partly false, sometimes true, mostly true and definitely true

ECU Motor Speech Disorders (16 decks)

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