Apraxia of Speech Flashcards
Definition of AoS
A neurological speech disorder that reflects an impaired capacity to PLAN or PROGRAM SENSORIMOTOR COMMANDS necessary for directing movements that result in phonetically and prosodically normal speech (patient is aware of their deficits and often attempt to correct them)
Non-speech and non-oromotor signs of AoS
- Right-sided weakness and spasticity
- Sensory deficits
- Limb apraxia
- Nonverbal Oral praxis (NVOA)
Describe and identify the features of speech that characterize AoS
- Articulation (CV distortions and simplification of target sounds)
- Rate and Prosody (slow overall rate and syllable segregation)
- Fluency (false starts and restarts)
Explain how various tasks can influence speech performance in patients with AoS
- Greater deficits in volitional and purposeful utterances rather than automatic and reactive utterances
- Imitative utterances will demonstrate greater deficits than spontaneous speech
- AMRs better than SMRs
- Iambic > trochaic (stress patterns)
- Nonsense words > meaningful words matched in complexity
Two types of restorative approaches for AoS and state their purpose
ARTICULATORY KINEMATIC (A-K) APPROACHES
RATE/RHYTHM APPROACH
Purpose of Articulatory Kinematic approach
Designed to provide frequent and intensive practice of speech targets
Focus is on accurate speech movement
External sensory input
Purpose of Rate/Rhythm approach
Makes use of intonation patterns to improve speech performance
Based on the idea that working to improve the prosody of speech will bring positive effects for articulation
Treatment Targets for A-K Approach
- Integral Stimulation
- Sound Production Treatment
- Prompts for restructuring oral muscular phonetic targets (PROMPT)
- Motor Learning Guided (MLG)
Treatment Targets for Rate/Rhythm Approach
- Pacing techniques
- Metrical Pacing Therapy (MPT)
- Singing
- Melodic Intonation Therapy
Other factors to be considered when making treatment decisions (COMPLEXITY)
- Starting with more complex targets may promote better generalization than simpler targets even if initial acquisition is difficult
Other factors to be considered when making treatment decisions (PRACTICE TYPE)
Distributed practice (spaced out) may be better than massed practice (a lot in a short amount of time)
Other factors to consider when making treatment decisions (RE: APHASIA TREATMENT)
Sometimes, an aphasia treatment may be appropriate:
- Multiple Input Phoneme Therapy (MIPT)
- Voluntary Control of Involuntary Utterances (VICU)
- Script Training
- Combined Aphasia and Apraxia of Speech Treatment (RET + SPT)
Other factors to consider when making treatment decisions (EXTERNAL)
Consider if AAC is appropriate
