Ch 11 AOS Flashcards
What is apraxia?
a problem with the motor programming of speech movements.
what is apraxia almost always due to?
left cerebral hemisphere damage
Steps in Speaking
- Speaker conceptualizes what is going to be said
- speaker formulates a message and activates plan (selecting semantics, syntactic, morphological, phonological structures)
- Program is sent through nervous system to produce muscle movement/motor execution
what is the result of a speaker not being able to formulate a message?
aphasia
what is the result of a speaker not being able to program/plan the necessary movements to produce the needed phonemes?
apraxia
What is the result when of the conceptualization of what is going to be said has difficulty going through the nervous system to produce muscles movement/ motor execution?
dysarthria
What is the difference between Broca’s aphasia and AOS?
individuals with AOS don’t have linguistic problems that are seen in Broca’s.
Which area in the pre-motor area is especially important for apraxia? People with apraxia are most often found to have lesions here.
Broca’s Area
Which area is not a common site of lesion for apraxia but may be sometimes involved?
Supplemental motor area -
The premotor areas are linked to which to areas for input?
- Basal Ganglia
2. Cerebellar Circuits
Which 2 areas are found to be important in integrating sensory information for skilled motor activity ?
Parietal Lobe Somatosensory Cortex
Supra marginal Gyrus
What has been considered a frequent site of lesion in apraxia?
The insula
What has also been found to be important in MSP?
Basal Ganglia
Lesions in which structure are also found to cause MSP?
Lesions in Striatum (putamen &globus pallidus)
What are some Non-Speech Characteristics that may accompany AOS and reflect LH Damage?
- some right-sided weakness
- babinski reflex and hyperactive stretch reflexes
- sometimes limb apraxia associated with LH pathology
- If limb apraxia is present in both Right and Left sides it may be masked on the right side by hemiparesis or hemiplegia
What are the main etiologies of AOS?
tumors, trauma, stroke
-anything that causes dominant hemisphere impairment of structures involved in motor planning.
What are some pt. complaints and perceptions with AOS?
- can’t produce words right- they know what they want to say but the words won’t come out right
- may worsen with stress
- don’t have probs with swallowing
- if c/o swallowing problems, neuromuscular problems may exist which would implicate dysarthria and dysphagia
What are the oral mech findings for AOS?
if dysarthria does not co-occur, then oral mech should be normal. (gag reflex, chewing, swallowing)
-no pathological oral reflex should exist without dysarthria.
What is non verbal oral apraxia?
problems with volitional movements of oral structures while the same movements may be performed involuntarily.
where are lesions for NVOA?
primarily LH.
-always assess for NVOA and Limb Apraxia in AOS eval/
How can you assess speech in AOS?
voluntary speech tasks (conversational speech tasks, reading, AMR’s)
what type of tasks are useful in assessing AOS?
tasks that requiring sequencing of various sounds and syllables, are especially useful as that is where the person with apraxia will break down.
- examples include SMR’s (puh-tuh-kuh) and multisyllabic words and sentences. (catastrophe, Mississippi)
- have pt. read words that become more complex in multi syllables (e.g endear, endearing, endearingly)
What should you watch for in AOS?
- groping of articulators.
- listen for false articulatory starts
what is the primary articulation error in in AOS?
distortion
