Ataxia Dysarthria

Question 1

Neurological basis

Answer 1

• cerebellum damage; or its pathways

Question 2

Ataxia means

Answer 2

lack of coordination

Question 3

Function of cerebellum

Answer 3

coordinating timing and force of muscular contractions

Question 4

Cerebella Ataxia - symptoms of ataxia

Answer 4

• disequilibrium - balance
• nystagmus
• intention tremor
• hypotonia
• problems with motor learning

Question 5

intention tremor

Answer 5

only during the performance of voluntary movements, such as reaching for a glass of water; closer your get to the target, the more you need the cerebellum and the more severe the tremor

Question 6

hypotonia

Answer 6

less tone but part of the job of the cerebellum is to take you to the tone, it can tell you that you need more tone for some of the muscles

Question 7

Etiologies

Answer 7

• degenerative diseases
• stroke
• toxic conditions
• TBI
• Tumors

Question 8

Etiologies - degenerative diseases

Answer 8

Friedreich’s ataxia
- progressive
- hereditary
- symptoms appear in late 20s

Question 9

Etiologies - stroke

Answer 9

• occlusions
• ruptured aneurysms
• cerebellum arteries: little one is easily ruptured, so it’s more hemorrhages

Question 10

Etiologies - toxic conditions

Answer 10

• lead, mercury, cyanide, etc.
• history of ETOH - alcohol/ethanol
• phenytoin (Dilantin)
• metabolic conditions: vitamin deficiencies, hypothyroidism

Question 11

Etiologies - TBI

Answer 11

• cerebellum
• cerebellar control circuit

Question 12

Etiologies - tumor

Answer 12

• cerebellum
• cerebellar control circuit

Question 13

speech characteristics

Answer 13

1. movements of speech mechanism are poorly coordinated
2. timing and force of muscular contractions for clearly articulated speech
3. “drunken speech”
4. “scanning speech” - monotone, robotic voice

Question 14

speech characteristic - articulation

Answer 14

Imprecise consonants
- slurred: ataxia clients are not weak, they are not uncoordinated
- irregular: they will switch back and forth between voiced and voiceless cognates; cuz they have trouble coordinating the switch between voiced and voiceless
- inconsistent errors

Vowel distortions

Question 15

speech characteristic - prosody

Answer 15

1. equal & excess stress
   - work harder to understand their speech
   - robotic speech
   - get tiring when listening to them
2. prolonged phonemes
3. prolonged intervals between phonemes
4. slow speech rate
   - increased pause time and/or articulation time
5. monopitch
6. monoloudness

Question 16

speech characteristic - phonation

Answer 16

harsh voice quality
- decreased muscle tone in laryngeal and respiratory structures

Question 17

speech characteristic - respiration

Answer 17

exaggerated or paradoxical movements
- excessive loudness variations
- reduced vital capacity
- speaking on residual air
- decreased loudness
- harsh voice quality

Question 18

Vital capacity

Answer 18

• total is made up of your vital
• residual is the 20% capacity but can’t access
• we don’t want it to be completely empty
• if there is no air, they will contract and cause edema

Question 19

key evaluation tasks

Answer 19

• AMRS: variable speech, irregular rhythm
• conversational speech and reading
• sentence repetition

They are not weak, and they don’t need strength training.

Question 20

Respiration treatment

Answer 20

Speak immediately on exhalation
- visi-pitch for visual feedback
** needs a lot of cueing
** cue immediately on exhalation

Stop phonation early
- verbal and visual cues

Optimal breath group
- syllables or words per breath

Question 21

Prosody treatment

Answer 21

• Pitch range exercises: Visi-pitch
• Intonation profiles: use written sentences to practice and protocol on visi-pitch
• contrastive stress drills
• don’t say “no” before the sentence no matter what
• chunking utterances into syntactic units

Question 22

Articulation treatment

Answer 22

• overarticulation of consonants
• minimal contrast drills: put the one they have trouble with the last