AOS and CAS Flashcards
AOS is problems with ____________ and ________.
motor planning and programming
T or F: AOS often exists in its pure form
False
What are the 3 definitions of AOS:
1) Cognitive Processing
2) Neuroanatomic
3) Behavioural
Describe the cognitive processing view of AOS:
Intact Linguistic level –> Impaired Motor Planning and programming level –> Execution
________ defines sensorimotor goals aka what needs to happen in the future.
Motor Planning
_______ defines commands for different muscle groups, depending on the specific articulatory situation, accounts for muscle tone, direction and range of motion. AKA what each muscle needs to do.
Motor programming
According to the neuroanatomic view what are the 4 brain areas associated with AOS:
1) Broca’s Area
2) Left Insula: subcortica structure along the cortico-bulbar pathway
3) Arcuate Fasciculus
4) Basal Ganglia
Based on the behavioural view of AOS there are 7 behavioural characteristics:
1) Reduced ability to perform skilled learned (esp. voluntary) movements.
2) Effortful/ groping articulation
3) Difficulty initiating
4) Articulatory inconsistencies on repeated productions
5) Prosodic disturbances
6) Automatic speech may be preserved or better
7) Increased difficulties with increased complexity or at a faster speaking rate
In the behavioural definition of CAS there are 3 segmental and suprasegmental features:
1) _________ errors on consonants and vowels in repeated production so syllables or words.
2) Lengthened and distrupted _________ between sounds and syllables
3) _______ especially in realization of lexical or phrasal stress (supresegmental duration, rate, stress, F0)
4) _________, inconsistency and imprecision
1) Inconsistent errors
2) Lengthened and disrupted co-articulatory transitions
3) Inappropriate prosody
4) Vowel errors
The _____________ is a standardized test for AOS that looks at DDKs, word repetition, limb/oral apraxia, complexity (polysyllabic word naming), successful repetitions, sponaneous vs automatic speech.
Apraxia Battery for Adults
___________ is the impaired ability to perform actions of the mouth and tongue. It is present in ____% of AOS cases.
Oral (non-verbal) apraxia
80%
_________ is impaired ability to repeat previously well-established actions
Ideation apraxia
________ is impaired ability to imitate unfamiliar actions, also called motor apraxia or ideokinetic apraxia
Ideomotor apraxia
_______ is impaired ability to copy simple drawings or patterns
Constructional apraxia
______ is impaired ability to dress
Dressing apraxia
________ is impaired ability to make eye movements, also called ocular apraxia.
Oculomotor apraxia
T or F: In CAS not only will automatic/ spontaneous supersegmentals may be intact they will also be able to imitate suprasegmentals.
False - automatic/ spontaneous may be intact but they won’t be able to imitate.
Tasks such as “stick out your tongue”, “bite your lower lip”, “show how you would kiss” and “whistle” are used to detect _______.
Oral Apraxia - which is present in 80% of AOS cases.
What are two main questions during AOS and CAS assessment?
1) Where does speech break down? - length, automaticity
2) What is the underlying issue? -artic or timing
What are some speech and sound production tasks used to assess apraxia?
- Imitation, spontaneous and repeated speech
- sounds, single syllables, multi-syllables, phrases, sentences
- Suprasegmentals (rate, pitch, volume, intonation)
During speech production consider __________ inventory not just error inventory.
phonetic
9 things to consider during speech production:
1) Phonetic/ error inventory
2) Consistency in repetition
3) Rich/ reduced sound/syllable repertoire
4) Groping
5) Organicity of imitated and spontaneous sounds
6) Typicality of errors
7) Omissions or substitutions
8) Disrupted sequencing
9) Stimuability
T or F: Spontaneous speech in apraxia is more motorically/ hetero-organic than speech on imitation.
True
T or F: “Go” is homo-organic (simple) and “open” is hetero-organically complex.
True
What is the difference between aphasia and apraxia?
Aphasia is linguistic processes
AOS is motor programming
What is the difference between dysarthria and apraxia?
Dysarthria is paresis, ataxia, akinesia, rigidity, dyskinesia or tremor
AOS is motor programming
What is the difference between severe phonological and apraxia?
phonological is a speech sound disorder
Differential Diagnosis:
Person has normal rate and can increase rate without increased errors
Aphasia
Differential Diagnosis:
Substitutions (>1 feature from target) are less common than distortions (1 feature away)
AOS
Differential Diagnosis:
Consistent location and type of error. Inconsistent repetitions.
AOS
Differential Diagnosis:
Slow rate. Increasing the rate increases errors.
AOS
Differential Diagnosis:
Long vowel durations and groping
AOS
Differential Diagnosis:
No difficulty on OME
Severe phonological or AOS without oral apraxia
Differential Diagnosis:
Decreased strength and coordination resulting in imprecision, slurring.
Dysarthria
Differential Diagnosis:
Errors are consistent in all utterance lengths
Severe phonological
Differential Diagnosis:
Omission in final position more likely than initial
Severe phonological
Differential Diagnosis:
Additions and tendency to omit initial sound
Apraxia of speech
T or F: CAS goes away with treatment and time.
False - can have residual or resolved CAS but speech is still apraxic. Stress, fatigue and alcohol make it worse.
Prognosis for CAS & AOS is generally good. It depends on _______ and ________
severity and amount of practice
List the 3 types of treatment for AOS and CAS
1) Articulatory positioning and transitioning
2) Prosody
3) Intersystemic reorganization
Describe articulatory treatment based on spatial features of sounds:
- Phonetic derivation (speech from non-speech)
- progressive approximation (get sh from s
- miming
- teach phonetic placement
- minimal pairs
The articulatory treatment of ___________ emphasiazes regaining point of articulation and sequencing and is 8 steps that are basically the cueing hierarchy
integral stimulation and repeated practice
__________ is for consonants. A unique feature is the use of minimal contrasts. The treatment uses minimal pairs to drill contrasts.
Sound production treatment (SPT)
_________ is for severe AOS. It is taking voluntary control of involuntary utterances. It slowly extends the # of phonemes and transitions.
Multiple input phoneme therapy
________ involves using promts for restructureing oral muscular phonetic targets.
PROMPT
________ focus on intonational, rhythmic and temporal aspects
Prosodic treatments
________ is a facilitating temporal schema.
Rhythm
List 5 prosodic treatments:
- melodic intonation therapy
- metronomic pacing/ finger tapping
- contrastive stress technique
- emotional stress
- prolonged speaking
T or F: prosodic treatments may be less effective by themselves than positioning methods
true
_________, _________ and _________ are intersystemic reorganization treatments.
pacing boards, finger counting and gesturing
List 5 Principles of Apraxia Treatment
1) Focus on Speech
2) Choose targets wisely
3) Prosodic treatments
4) Cueing hierarchy and hierarchy of difficulty
5) Severity
How should you choose targets in AOS:
- Functionality
- Treat non-stimuable sounds for treatment generalization but consider frustration
- Consider difficulty of sounds, frequency of occurance, isolated vs syllable
- How many sounds to target and practice schedule
T or F: High intensity is better than low intensity in CAS
True - 3-5 sessions/ week
T or F: Naturalistic environment as possible
True
T or F: 2 hour long sessions are better than four 30 minutes sessions.
False- more short sessions better
T or F: Use a multisensory approach
True
T or F: Treat the individual and consider the entire speech system.
True
- increase phonetic inventory
- decrease errors
- increase suprasegmentals
