Apraxia of Speech

Question 0

Motor Speech Programmer

Answer 0

• organizes the motor commands that result in correct production of speech
• involves transformation of phonemes into neural code
• relies on Broca’s area (most common lesion site for AOS)

Question 1

Definition

Answer 1

• a sensorimotor disorder of articulation and prosody
• impaired capacity to program the positioning of speech muscles, and sequencing movements for volitional production of speech

Question 2

Causes

Answer 2

• demyelinating disorders (MS)
• Stroke (most common cause)
• tumours and trauma

Question 3

Patient perceptions

Answer 3

• center on articulation and rate
• surprised by errors
• talk slowly
• think they stutter
• worsens under fatigue
• no swallowing/drooling problems

Question 4

Assume ______

Answer 4

APHASIA (b/c high degree of co-occurrence)

Question 5

OME observations

Answer 5

• may have oral sensory deficits
• normal gag
• NVOA / limb apraxia

Question 6

Speech tasks to get them to do

Answer 6

• conversation & reading
• imitative tasks using complex multisyllabic phrases
• SMRs (if they can do AMRs but not SMRs think AOS)
• Simple tasks to compare
• CVCs w/ duplicated consonants

Question 7

Speech characteristics

Answer 7

• groping / silent posturing
• dysprosody
• difficulty initiating
• inconsistency
• slow rate
• low frequency more difficult
• longer words more difficult
• distorted vowels

Question 8

AOS vs Aphasia

Answer 8

• AOS: more groping, worse SMRs, decreased accuracy w/ increased complexity
• Broca’s: more grammatic/syntactic errors, word retrieval problems, verbal comprehension problems
• Fluent: more normal prosody and ease of production

Question 9

AOS vs Dysarthria

Answer 9

• AOS: more groping, less consistency, mismatch btwn automatic & volitional, normal CN

Question 10

Childhood AOS

Answer 10

• occurs in early childhood
• hard to determine
• high level motor control deficits

Question 11

Causes of CAS

Answer 11

• genetics?
• trauma?
• Gender bias? Male:female, 2-3:1

Question 12

Motor theory of CAS

Answer 12

• caused by disruption in feedback mechanisms

- deficit in development and control of speech timing

Question 13

Linguistic theory of CAS

Answer 13

• impaired ability to develop and use phonetic/phonological hierarchies

Question 14

Motolinguistic theory of CAS

Answer 14

• motor deficit would affect child’s acquisition of phonological skills, since they acquire both skills simultaneously

Question 15

Nonspeech observations of CAS

Answer 15

• normal receptive lang
• awkward or clumsiness
• difficulty w/ volition oral movements
• abnormal orosensory perception

Question 16

Speech observations of CAS

Answer 16

• difficulty sequencing sounds
• groping
• incorrect prosody
• hypernasality
• increasing errors w/ increasing complexity

Question 17

CAS vs Dysarthria

Answer 17

• no known neural substrate
• no muscle weakness
• affected by automaticity and familiarity
• SMRs poorer than AMRs