Adult Neuromotor Conditions Flashcards
What are neuromotor conditions?
Any condition affecting one or multiple speech processes brought about by damage to the nervous system
What is apraxia of speech (AoS)? What is usually damaged?
- Neurogenic speech disorder characterized by problems in creating motor plans and/or sequencing moving muscles for producing speech
- In isolation, NO muscular weakness present
- Inconsistent articulatory errors; more apparent on longer utterances
- Usually present when damage is located on the frontotemporal region of the (L) hemisphere of the cerebrum
What is dysarthria?
- Neurogenic speech disorder affecting respiration, phonation, prosody, resonance, and/or articulation due to problems with strength, mobility, and/or endurance
- Has different types that depend heavily on which part of the brain is damaged
What is the difference between apraxia of speech and dysarthria?
AoS and Dysarthria may co-occur
- AoS has inconsistent errors while dysarthria usually has consistent errors
- Aos–the more complex, the more errors, while dysarthria complexity has no effect on errors
- In AoS, automatic speech has less errors, while with dysarthria automatic speech has no effect on errors
- AoS–repetition = fewer errors (however this may not be always true), while for dysarthria, repetition alone has no effect on errors
Lesion site of this type of dysarthria (spastic)
Upper motor neuron (bilateral)
What is the neurologic basis of spastic dysarthria
- Weakness
- Spasticity
Speech characteristics of a person with spastic dysarthria
- Articulation - imprecise consonants, distorted vowels
- Prosody - slow rate, reduced stress
- Phonation - hyperadduction of vocal folds, breathy, hoarse, pitch breaks, mono pitch/loudness
Lesion site for flaccid dysarthria
LMN
Neurological basis for flaccid dysarthria
- Weakness
- Hypotonia
Speech characteristics of flaccid dysarthria
- Articulation - weak pressure consonants
- Prosody - short phrases
- Phonation - breathy, monopitch, hoarse
- Resonance - nasal emission, hypernasal
- Respiration - weak subglottic pressure → breathy voice
Lesion site for hypokinetic dysarthria
Basal ganglia or basal ganglia connection within CNS (Parkinson’s disease)
Neurologic basis for hypokinetic dysarthria
- Reduced range of movement, rigidity, reduced movement (hypo-less or reduced movements)
Speech characteristics of hypokinetic dysarthria
- Articulation - imprecise/distorted consonants
- Prosody - short rushes of speech, increased rate in segments of utterances, “stuttering”
- Phonation - monopitch, low vocal loudness
Lesion site of hyperkinetic dysarthria
Basal ganglia or basal ganglia connection within CNS (Huntington’s diseases, Syndenham’s Chorea)
Neurologic basis of hyperkinetic dysarthria
- Abnormal, extra movements
- “Hyper” - more movements
Speech characteristics of hyperkinetic dysarthria
- Articulation - imprecise consonants, distorted vowels
- Prosody - slower rate of speech, prolonged interword intervals, inappropriate silent periods, excess/equal stress
- Phonation - difficulty varying pitch/loudness
- Respiration - audible inspiration, sudden inspiration/expiration
Lesion site of ataxic dysarthria
Cerebellum
Neurologic basis of ataxic dysarthria
Incoordination
Speech characteristics of ataxic dysarthria
- Articulation – irregular articulatory errors, imprecise consonants, distortion of vowels
- Respiration – exaggerated inhalation/exhalation, mistimed breathing during speech
- Prosody – excessive stress, prolonged phonemes and intervals between words or syllables (“drunken speech”), slow rate of speech
Lesion site of unilateral upper motor neuron
UMN (unilateral)
Neurologic basis of Unilateral upper motor neuron
- Weakness, spasticity
Speech characteristics of unilateral upper motor neuron
Phonation – hoarseness, reduced loudness, monopitch, monoloudness (very hoarse)
Other areas similar to spastic dysarthria
Lesion site of mixed dysarthria
Damage to various parts of the nervous systems (neurodegenerative diseases)
Sample mixed dysarthria and conditions
- Flaccid-spastic (ALS–Amyotrophic lateral sclerosis )
- Ataxic-spastic (MS–multiple sclerosis → attacks the spine or brain)
- Flaccid (GB–Guillain-Baré syndrome → attacks the PNS)*
- Mild dysarthria (MG–myasthenia gravis)*
Speech characteristics of mixed dysarthria
Depends on the affected parts of the nervous system
