Adult dysphagia, dysarthria, Apraxia

Question 1

intervention targets for Dyspraxia

Answer 1

Restore: automatic speech: sing-> speech, use trigger phrases: this is a knife, this is a …(fork), intergal communication (slowly reduce modelling until independent, step downs)

compensate: speaker listener and environmental changes, (examples…..)
substitute: alternative communication (boards, eye-gaze)

Question 2

intervention targets for dysphagia

Answer 2

restore: OME, rehab exercises (chin tuck, Shaker), therapeutic feeding (trials for oral intake)
compensate: posture, maneuvers, IDDSI, texture modification (level 0 fluids), bolus delivery modification (straws),
substitute: non oral feeding (PEG)

Question 3

Intervention targets dysarthria

Answer 3

Restore: OME (sometimes), excercises to practice sounds

compensate: speaker (reduces rate, room (close door)),
subsititute: AAC, change life/work/family set up , picture boards, point, change activities to reduce need for speech

Question 4

name dysphagia rehabilitation techniques and their purpose

Answer 4

chin tuck = stand up and look down to feet (no food)
masako= put tongue between teeth and hold it while swallowing saliva (no food), strengthenstongue for bolus manoeuvre.
Medelsohn/3 sec bolus hold= find larynx and feel is move up when swallowing saliva, then gently hold larynx up when swallow has been initiated. 3 sec and then lower. slows down the swallow process and reduces chance of aspiration.
Shaker= lie down, lift head looking to feet, hold up to 1min, repeat 3 times, then short head lifts 30 times, 3 times a day (no food). strengthens suprahyoid muscles

Question 5

3 considerations in starting treatment in motor speech disorders

Answer 5

client wishes, history, risk
Risk:Risk (as related to swallowing):

                                         * Of aspiration
                                         * Of choking
                                         * Of dehydration
                                         * Of malnutrition

                              Risk is increased by many factors, including (but not limited to):

                                        * Past history
                                        * Chair-side evidence
                                        * Presence of carer
                                        * Absence of knowlegable and regular GP
                                        * Reduction in overall health