Apraxia: Assessment and Treatment

Question 1

What are the three other names for Apraxia of Speech (AOS)?

Answer 1

• verbal apraxia
• acquired apraxia of speech
• dyspraxia

Question 2

What are some characteristics of AOS? (10)

Answer 2

• omissions/substitutions/distortions
• put sounds together
• groping
• automatic speech=easy
• longer utterances=hard
• initiation of sounds=hard
• diff mistakes on same word
• slow speaking
• prosody/rhythm affected
• awareness of deficits

Question 3

APRAXIA is difficulty with…

DYSARTHRIA is difficulty with…

Answer 3

…PLANNING

…EXECUTION

Question 4

What are some disorders that AOS can co-exist with?

Answer 4

• aphasia (brocas area)

- dysarthria

Question 5

What are the concomitant cognitive deficits people with AOS have?

Answer 5

• emotional liability

- attentional deficits

Question 6

Name 5 other types of apraxia

Answer 6

• ideomotor (imagery)
• ideational (order)
• constructional (draw)
• gait (posture)
• dressing

Question 7

What is something we must apply in treatment of AOS?

Answer 7

• rules of motor learning

Question 8

What are different ways we can adjust the treatment procedure? (6)

Answer 8

• specificity
• intensity
• practice variabilities
• practice schedule
• complexity
• feedback=key

Question 9

What is the concept of pre-practice?

Answer 9

• get buy in
• motivation
• what working on and why?

Question 10

What are the three principles of treatment used for people with AOS?

Answer 10

1. Articulatory
2. Prosodic
3. Tactile

Question 11

In articulation, what are the three methods used?

Answer 11

• sound production
• integral stimulation
• MIPT

Question 12

What severity of AOS is appropriate for integral stimulation?

Answer 12

• moderate to severe apraxia

Question 13

What is the method of integral stimulation and what is it known as?

Answer 13

• for training motor pathways for speech production

- “watch me, listen, do as i do”

Question 14

How does integral stimulation typically work?

Answer 14

• begin with clint imitating clinicians model (decrease cuing)
• 8 step continuum

Question 15

For people with severe apraxia, what should we work on?

Answer 15

• start with vowels, then CV, VC

- choose functional words (for everyone)

Question 16

What does MIPT articulation treatment stand for? and who is it used with?

Answer 16

Multiple Input Phoneme Therapy

- severe apraxia with verbal ‘stereotypes’ (use to adv)

Question 17

What is sound production treatment?

Answer 17

• combinations of different articulatory treatments

- teaches you how to produce consonant sounds

Question 18

What are the different concepts used in sound production treatment?

Answer 18

• phonemic placement
• cueing hierarchy
• minimal pairs

Question 19

How do we promote transfer?

Answer 19

• involve diff communication partners

- involve diff speaking contexts

Question 20

What are the two prosodic treatment types?

Answer 20

• MIT (melodic intonation therapy)

- Contrastive Stress

Question 21

What does MIT stand for? How does it work?

Answer 21

• prosodic approach
• focuses on intonation patterns
• clinician models rhythmic tapping while saying short phrase

Question 22

What are the 5 stages in MIT therapy?

Answer 22

1. hum phrase together
2. sing together, tap patients left hand once per syllable
3. fade your singing
4. have patient repeat after you
5. ask probe question, ask patient to answer using practiced phrase

Question 23

In MIT, what is the “melody” based on?

Answer 23

the natural intonation pattern of the spoken phrase

Question 24

What is contrastive stress therapy?

Answer 24

• prosodic approach
• focus on stress pattern and intonational contour
• clinician asks questions, the person with AOS must modify stress pattern in the phrase to answer q

Question 25

Who should use AAC as a treatment for AOS?

Answer 25

• those with little functional verbal communication
• sign language
• speech output devices