Ataxia Dysarthria Flashcards
Neurological basis
- cerebellum damage; or its pathways
Ataxia means
lack of coordination
Function of cerebellum
coordinating timing and force of muscular contractions
Cerebella Ataxia - symptoms of ataxia
- disequilibrium - balance
- nystagmus
- intention tremor
- hypotonia
- problems with motor learning
intention tremor
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
hypotonia
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
Etiologies
- degenerative diseases
- stroke
- toxic conditions
- TBI
- Tumors
Etiologies - degenerative diseases
Friedreich’s ataxia
- progressive
- hereditary
- symptoms appear in late 20s
Etiologies - stroke
- occlusions
- ruptured aneurysms
- cerebellum arteries: little one is easily ruptured, so it’s more hemorrhages
Etiologies - toxic conditions
- lead, mercury, cyanide, etc.
- history of ETOH - alcohol/ethanol
- phenytoin (Dilantin)
- metabolic conditions: vitamin deficiencies, hypothyroidism
Etiologies - TBI
- cerebellum
- cerebellar control circuit
Etiologies - tumor
- cerebellum
- cerebellar control circuit
speech characteristics
- movements of speech mechanism are poorly coordinated
- timing and force of muscular contractions for clearly articulated speech
- “drunken speech”
- “scanning speech” - monotone, robotic voice
speech characteristic - articulation
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
speech characteristic - prosody
- equal & excess stress
- work harder to understand their speech
- robotic speech
- get tiring when listening to them - prolonged phonemes
- prolonged intervals between phonemes
- slow speech rate
- increased pause time and/or articulation time - monopitch
- monoloudness
speech characteristic - phonation
harsh voice quality
- decreased muscle tone in laryngeal and respiratory structures
speech characteristic - respiration
exaggerated or paradoxical movements
- excessive loudness variations
- reduced vital capacity
- speaking on residual air
- decreased loudness
- harsh voice quality
Vital capacity
- 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
key evaluation tasks
- AMRS: variable speech, irregular rhythm
- conversational speech and reading
- sentence repetition
They are not weak, and they don’t need strength training.
Respiration treatment
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
Prosody treatment
- 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
Articulation treatment
- overarticulation of consonants
- minimal contrast drills: put the one they have trouble with the last
