apraxia Flashcards
apraxia of speech
neurogenic speech disorder with deficits in motor planning and programming
features of apraxia
-slow overall speech rate
-increased sound distortions or distorted sound substituitons with increased utterance length or increased syllable/word articulatory complexity
-sound distortions
-groping
limb-kinetic apracia
-loss of kinetic functions for one limb
-usually their right hand, but can be other limbs
ideational apraxia
deficits in the execution of complex sequential movements. some consider it a severe form of ideomotor apraxia (pa ta ka)
ideomotor apraxia
deficits in execution of learned movements in spite of intact mobility, sensation, coordination, and comprehension (know how to cough, pucker, etc. but cant on command)
assessment of limb apraxia
-begin with least challenging tasks (pucker lips, smile)
-gestural tasks should include trails with imitation, trials on commands, and self generated trials
assessment of oral apraxia
-begin with least challenging gestures (nonrespiratory intransitive gestures) (close lips, stick out tongue)
-elicit responses under different conditions (with modeling, following commands, and self-generated trials)
primary diagnostic criteria
-slow rate of speech, including lengthened sound segments and intersegment durations
-sound distortions
-distorted, perceived sound substitutions
-inconsistent errors
-prosodic errors
nondiscriminative characteristics of AOS
-articulatory groping
-perseverative errors
-increasing errors with increasing word length
-deficits in speech initiation
-automatic speech better than propositional speech
treatment effects are examined based on 2 variables
-response generalization
-stimulus generalization
response generalization
-treatment effects are assessed based on performance of either untrained examples of trained behaviors
stimulus generalization
treatment effects are carried over outside of the therapy session (home, store, etc.)
general treatment categories
-articulatory kinematics
-rate.rhythm
-AAC
-intersystemic facilitation/reorginzation
response elaboration training *
clinican encourages client to produce an utterance of choice in response to picture stimuli. clinican then uses reinforcement, modeling, and forward chaining to expand the utterance
-use for aphasia and apraxia
modified version of RET*
focus on increasing language production and techniques to promote speech production. this does not include specfic treatment techniques for apraxic speech production errors
sound production treatment (SPT)
improve artic. of target sounds at word, phrase, and/or sentence level. includes modeling, repetition, minimal pairs, integral stimulation, artic. placement cueing and feedback
combined aphasia and apraxia of speech treatment
includes modified version of RET and SPT to increase generalization of verbal lang. skills and to improve speech production
when apraxia presents as the only predominant symptom of a neurodegenerative condition, it is called
primary progressive Apraxia
limb gestures
-distal gestures
-proximal gestures
-intransitive gestures
-transitive gestures
distal gestures
fine motor skills
proximal gestures
-gross motor skills
-people with apraxia typically have trouble with distal compared to proximal
-proximal develops 1st
intransitive gestures
do not require a tool (smiling, coughing)
transitive gestures
do require a tool or object (brushing hair/teeth, blowing bubbles)
-people with apraxia have more difficult with transitive gestures
types of oral gestures
-transitive
-intransitive
-respiratory gestures
-nonrespiratory gestures
transitive oral gesture
drink out of cup
intransitive oral gesture
pucker lips
respiratory gestures
involve breathing (whistling, yawning)
-harder
nonrespiratory gestures
do not involve breathing (smiling, laughing, coughing)
easy to do
proximal, intransitive, away from the body movement (waving goodbye, giving high-five, shaking hands)
hard to do
distal, transitive, on the body movements (putting on makeup, tweezing your brows)
articulation ex (response generalization)
-untrained example of trained behaviors (gliding r-words, l-words)
-related behaviors (working on initial consonant deletion have them produce word lists and they can carry over same knowledge to final)
reading ex (response generalization)
untrained ex of trained behaviors
-functional 10 phrases, give them new phrase, perform with new phrase
