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adult speech Flashcards

1
Q

A disorder of motor execution

A

dysarthria

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2
Q

assessment steps for dysarthria

A

information gathering
cog-comm assessment/language
- orientation
- 1-2 step directions
- expressive language
-receptive language
oral peripheral exam
- muscle strength, ROM, speed, accuracy
auditory peripheral exam
diadochokinesis
connected speech sample

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3
Q

formal assessment for dysarthria

A

Frenchay Dysarthria Assessment (12+)

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4
Q

muscular weakness, hypotonia, stiffness/tightness

A

spastic dysarthria

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5
Q

etiologies for spastic dysarthria and SoL

A

CVA
als, ms
brainstem stroke
TBI
inflam disease

bilateral upper motor neurons

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6
Q

speech production errors - spastic dysarthria

A

resp - generally not an issue
artic - imprecise consonants
prosody - monopitch, monoloudness, reduced pitch
res - hypernasal
phonation - harsh vocal quality, strain-strangled

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7
Q

assessment for spastic

A

conversational speech
diadochokinesis
- AMR highlight slowed rate
vowel prolongation

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8
Q

Treatment for spastic

A

resonance - surgical flap, teflon injection, palatal lift
- velar strengthening - blowing and sucking, ^ loudness, slow rate, open mouth
artic - intell drills, phonetic placement, exaggerating, minimal contrast
prosody - pitch range, intonation profiles, contrastive stress
phonation - head and neck relax, easy onset, yawn- sigh

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9
Q

muscular weakness and hypotonia

A

flaccid dysarthria

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10
Q

etiologies for flaccid dysarthria
and sol

A

mysathenia gravis
polio
guillain-barre
tumors
brainstem stroke
sol - lower motor neurons in one or more cranial or spinal nerves

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11
Q

flaccid dysarthria speech production errors

A

respiration - shallow breathing, stridor
resonance - hypernasal
artic - imprecise consonants
prosody - reduced pitch and loudness
phonation - breathy

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12
Q

assessment for flaccid dysarthria

A

convo speech and reading
AMRs highlight slow rate
prolonged vowel for breathiness
speech stress in suspected myasthenia gravis

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13
Q

treatment for flaccid

A

respiration - correct posture, speak immediately on exhalation
resonance - increase loudness, reduce rate, open mouth
artic - intell drills, phonetic placement, exaggerating consonants
prosody - pitch range, intonation, contrastive stress, chunking utterance
phonation - pushing and pulling, holding breath, hard glottal attack

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14
Q

imprecise, jerky, poorly coordinated movements, inaccurate force, range, timing, direction

A

ataxic dysarthria

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15
Q

etiologies and site of lesion for ataxic

A

SoL- cerebellum
- degen diseases
- CVA
- toxic conditions
- TBI
- Tumor

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16
Q

speech production errors for ataxic

A
  • respiration - slow and controlled, speak on exhale, stop phonation
  • artic - traditional artic therapy
  • prosody - rate control and stress/ intonation: contrastive stress drills, pitch range, intonation
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17
Q

hyperkinetic dysarthria sol and etiologies

A

Huntingtons TBI stroke infections

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18
Q

excessive and involuntary movements

A

hyperkinetic dysarthria

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19
Q

site of lesion and eitologies for hyperkinetic

A

basal ganglia
huntington’s
tbi
cva
infections

20
Q

speech production errors for hyperkinetic

A

resp - unexpected inhalations or exhalations
reson - hypo or hypernasal
artic - imprecise consonants
prosody - prolonged intervals, pitch, monopitch
phonation - harsh, strain/strangled

21
Q

assessment for hyperkinetic

A

vowel prolongation
AMRs- speech rate variations, breakdowns
convo speech

22
Q

muscle rigidity, reduced ROM, slowed movement

A

hypokinetic dysarthria

23
Q

SOL and etiologies for hypokinetic

A

basal ganglia
- TBI
- CVA
- tumors
- infections
- anoxia

24
Q

speech production errors for hypokinetic

A

resp - reduced breath support impacts loudness and phonation
res- no
artic - imprecise consonants
prosody - monopitch, monoloudness, reduced stress, increased rate
phonation - breathy and soft

25
Q

assessment for hypokinetic

A

convo speech - rate and prosody errors
AMRs - artic errors
vowel prolongation - vocal quality

26
Q

treatment for hypo

A

compensatory
resp- speak immediately on exhalation, cues to increase inhalation, slow and controlled exhalation
prosody- rate control, intonation stress profiles, drills
phonation- voice amps
LEE SILVERMAN TREATMENT

27
Q

main types of intervention dysarthria

A

compensatory techniques - slowing down, over artic, open wide
environmental - provide main topic before speaking, watch for turn-taking, ask yes/no
communication repair strategies - total rep, partial rep, spelling the first few letters, elaboration, simplifying message

28
Q

a deficit in the ability to smoothly sequence the tongue lips, jaw; a disorder of motor planning

A

apraxia of speech

29
Q

clinical characteristics of AOS

A

artic - subs and distortions
rate - slowed, lengthened segments, increased intersegment durations
prosody - equal stress, pitch and loudness errors
automatic speech less impacted
errors increase with word length
artic groping

30
Q

assessment for AOS

A

AMR pa pa pa, ta ta ta, ka ka ka
SMR ptk
(SMR more effected)
muscle strength and ROM
Apraxia Battery for Adults
Behavioral checklists

31
Q

Treatment for AOS

A

Hierarchy of difficulty
Modeling and repetition
various placement cues
minimal pairs
Rosenbek 8-step continuum
Sound production Treatment
Script Training
Metrical pacing
Hand tap

32
Q

Rosenbek 8-step continuum

A

max to min cues
watch me listen to me then simultaneous production
end - role playing

33
Q

sound production treatment hierarchy

A

target
minimal pair item
printed letter
integral stimulation
artic placement cues

34
Q

disorders in oral domain

A

lip closure
tongue control during bolus hold
bolus preparation/mastification
bolus transport/ lingual motion
initiation of pharyngeal swallow

35
Q

disorders in pharyngeal domain

A

soft palate elevation
laryngeal elevation
anterior hyoid movement - partial/ no movement affects larynx elevation, epiglottis inversion
epiglottis movement
laryngeal vestib control
pharyngeal stripping wave
pharyngeal contraction

36
Q

cranial nerves involved in swallowing

A

5 trigeminal
7 facial
9 glossopharyngeal
10 vagus
11 spinal accessory
12 hypoglossal

37
Q

signs and symptoms of dysphagia

A

drooling/increased secretions
weight loss
coughing/choking
difficulty chewing/ pocketing
swallow delay
changes in diet
food stuck
nasal regurgitation

38
Q

assessment for dysphagia

A

Chart Review
Patient Interview and Observations
Bedside Eval
-oral mech
-respiratory check
-position patient
-ask to swallow before anything in the mouth
-ice chip spoon
-during trials, place hand under chin
-consistencies- ice chips, water/thin, nectar, pudding, solid
SAFE
MASA
MBS
FEES

39
Q

allows you to see oral and pharyngeal phase

A

Modified Barium Swallow Study

40
Q

passes transnasally to the pharynx can only see pharyngeal stage before and after swallow

A

FEES

41
Q

Compensatory techniques for dysphagia

A

seating - up straight if able
chin down
head rotation to weak side - closes off weak
backward head tilt
sour bolus
food placement
external cheek pressure
labial support
chin support
labial and chin support
smaller bites, spoon only, multiple swallows
supraglottic swallow
effortful swallow
Mendelsohn

42
Q

supraglottic swallow (5 steps)

A

Take a breath/hold it
take a bite of food/sip
swallow (hold breath)
cough on exhale
swallow again

43
Q

diet changes

A

thin liquids, nectar/honey/pudding, mechanical soft

44
Q

thin liquids best for

A

reduced pharyngeal wall contraction, reduced cricopharyn opening

45
Q

nectar/honey/pudding best for

A

poor bolus control, delayed swallow trigger

46
Q
A

comps (4 decks)

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