Adult Neuromotor Assessment Flashcards
What is the purpose of a motor speech evaluation?
Identifying the following:
- Current state of OPM structures
- Type and nature of errors
- Severity
- Activity limitations, and participation restrictions (ICF)
- Candidate therapy procedures
Important questions/information to get during case history
- Onset: Is it sudden or gradual
- Site of lesion: the site of lesion will give you an impression of what type of dysarthria it is
- Patient or family members’ perception on patient’s speech
- Other concerns with communication and/or swallowing
What is an OPM Assessment?
Check strength, endurance, range of motion, and accuracy of muscles
Speech tasks (DDK rate) and non-speech tasks → AMR and SMR
Facial symmetry will let a clinician know if the patient has facial drooping on one side during an OPM assessment. True or False.
True
Facial drooping on one side will tell you that the patient may have, what kind of dysarthria?
Unilateral Upper Motor Neuron Dysarthria → This type of dysarthria typically results from damage to the upper motor neurons on one side of the brain, which can cause weakness or paralysis in the muscles of the face, especially on one side. It often accompanies strokes or other lesions affecting the cerebral hemisphere or brainstem. The speech characteristics may include imprecise articulation, slow rate, and sometimes mild vocal harshness.
Why is it important to check the lip movements during an OPM assessment?
This is needed for precise vowels
Why is it important to assess the following: puffing cheeks?
This will let you know the following:
- Lip closure
- Velum closure
- Puffing the cheeks also assesses the patient’s ability to control intraoral pressure, which is important for both speech and swallowing. The ability to generate and maintain intraoral pressure helps with:
Articulation of certain speech sounds (e.g., fricatives like /s/, /sh/)
Efficient swallowing, particularly in managing liquids
What is the speech task to assess the lips?
Production of /puh/
What is the speech task for the jaw?
Production of /juh/ or “yuh”
True or False. The tongue will lead towards the affected side because the affected side will not have “enough muscle tone”
True → The tongue will deviate toward the affected side during protrusion because the affected side lacks sufficient muscle tone or strength. This occurs due to weakness or paralysis of the tongue muscles on the affected side, commonly caused by damage to the hypoglossal nerve (cranial nerve XII). The stronger, unaffected side will push the tongue toward the weaker side, resulting in the deviation.
Speech tasks to assess tongue movement
Speech tasks: /tuh/ and /kuh/
What do we ask the patient to do when we assess the velum?
Elevation while phonating → ah ah ah
Phonate /u/ then check if air comes out of the nose → The velum should elevate to close off the nasal passage and prevent air from escaping through the nose during phonation. This is a test of the velopharyngeal closure during speech.
Another way to assess this is to occlude the nose while producing /u/
What do you assess to check the larynx/vocal folds?
Check if there is audible breathing
- Sharp cough → if the px is having difficulty, the px may have difficulty adducting the vocal folds (there is not enough subglottic pressure or the px may not have enough “air” or breath support)
- Glottal stop - “uh” but with force so forceful closure of the closure, if the patient is able to do that accurately, the adductor muscles are not the problem
- Sustain phonate /a/ → check the breath support
Why is speech assessment important?
If there are any errors that are present
Describe the errors (SODA), and in which level does it affect speech
Take not of cultural differences
So from word level → phrase → sentence → reading passages → conversation
Standardized assessment
Uncommonly used in the country
Gives values to perceivable/observable traits of a patient’s speech
