asses. of organic and neuro speech Dis. Flashcards
Cerebral palsy
- pre, peri, post natal.
- not progressive
Spastic Cerebral Palsy
- 50% of kids have this
- slow jerking movements with increased muscle tone
athetoid cerebral palsy
- 10% of kids
- slow writhing and involuntary movements
Ataxic cerebral palsy
- 5-10% of kids
- balance problems and normal reflex
- normal muscle tone
Rigid cerebral palsy
- 1% of kids
- simultaneous contraction of all muscle groups
mixed cerebral palsy
- 30% of kids
- might have several of these
Speech problems and their assessment
- Oral motor: we have to asses both speech and non speech
- feeding
- slow DDK rates, discoordination of tongue, slow w/ that
- resonance
prosody
(intonation) monotone mostly
respiration
- sometimes very breathy
- rapid breathing and wasted air and trailing off the end of sentences
phonation
-a weak and strained voice because of hyperadducted vocal cords (theyre stuck together)
articulation
- producing a speech sound
- weak pressure consonance and imprecise
Dysarthria
- neuromotor disorder affecting all systems (respiration, phonation, articulation, resonance, prosody)
- due to: CP, degenerative diseases., stroke
characteristics to look for in asssessment
- breathy respiration
- difficulty with appropriate syllable stress
- artic: imprecise, distorted consonants; weak pressure consonant (use MOOSE)
- resonance hypernasality
- phonation: monotone, monoloudness, often soft voice
festination
means small shuffling steps
Childhood apraxia of speech
- inconsistent errors
- flat prosody
- difficulty sequencing sounds and syllables
- moderately to severely unintelligible
owens, farinella and metz
- CAS is not the result of weakness
- ch. w/ CAS have impaired motor planning and programming capabilities
- unable to automatically learn motor plans necessary for rapid, accurate speech production
- better at word level (single words) than connected speech
Associated problems w childhood apraxia
- family history in some ch.
- possible learning disability
- BETTER RECEPTIVE lang increase, lower expressive lang]
- slow therapy progress
- oral apraxis/difficulty with volitional non speech tasks
- slow DDKs
- ‘soft’ neurological signs – gross and fine motor incoordination (clumsy)
Assessment– evaluate
CAS 1
- Pitch, loudness, prosody
- overall intelligibility
- resonance – e.g., hypernasal
- DDKs – alternating /p^p^p^/
and sequential /p^t^k^/
CAS assessment 2
- sample production of same phoneme in multiple trials
- ask them to produce words in both imitative and spontaneous modes
- developmental history – feeding, sucking problems? slow lang devt?
CAS assessment 3
- volitional nonspeech movements of oral muscles in isolation and in sequence
- receptive and expressive lang skills
- articulation – give test , admin items repeatedly to assess consistency of production
- connected speech sample
Roseberry favorite CAS assessment
- production of POLYSYLLABIC WORDS– have them say the words several times, check for CONSISTENCY
cleft palate
opening in normally close in a normally closed structure
combined cleft palate and lip
can be unilateral or bilateral
Assessment of cleft palate patients
- difficulty with PRESSURE CONSONANTS (stops, fricatives, affricates)
- nasal emission, hyponasality
- compensatory errors like glottal stops -> hoarseness
- middle ear dysfunction, OME
Asses of cleft palate patient 2
- Iowa pressure test
- watch for expressive-receptive lang gap (receptive always better)
- listen for vocal pathology like hoarseness, soft voice due to strain on vocal folds or to VPI
Assessment strategies
- work with team professionals
- help plan surgical interventions
- Assess intelligibility in connect speech
- esp. asses production of pressure consonants in words and sentences
- determine presence of hypernasality on vowels and nasal emission on consonants
hold w mirrors under the childs nose
- have her prolong /I/
- mirror should be clear if there is no hypernasailty
