Ch 11 AOS

Question 1

What is apraxia?

Answer 1

a problem with the motor programming of speech movements.

Question 2

what is apraxia almost always due to?

Answer 2

left cerebral hemisphere damage

Question 3

Steps in Speaking

Answer 3

1. Speaker conceptualizes what is going to be said
2. speaker formulates a message and activates plan (selecting semantics, syntactic, morphological, phonological structures)
3. Program is sent through nervous system to produce muscle movement/motor execution

Question 4

what is the result of a speaker not being able to formulate a message?

Answer 4

aphasia

Question 5

what is the result of a speaker not being able to program/plan the necessary movements to produce the needed phonemes?

Answer 5

apraxia

Question 6

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?

Answer 6

dysarthria

Question 7

What is the difference between Broca’s aphasia and AOS?

Answer 7

individuals with AOS don’t have linguistic problems that are seen in Broca’s.

Question 8

Which area in the pre-motor area is especially important for apraxia? People with apraxia are most often found to have lesions here.

Answer 8

Broca’s Area

Question 9

Which area is not a common site of lesion for apraxia but may be sometimes involved?

Answer 9

Supplemental motor area -

Question 10

The premotor areas are linked to which to areas for input?

Answer 10

1. Basal Ganglia

2. Cerebellar Circuits

Question 11

Which 2 areas are found to be important in integrating sensory information for skilled motor activity ?

Answer 11

Parietal Lobe Somatosensory Cortex

Supra marginal Gyrus

Question 12

What has been considered a frequent site of lesion in apraxia?

Answer 12

The insula

Question 13

What has also been found to be important in MSP?

Answer 13

Basal Ganglia

Question 14

Lesions in which structure are also found to cause MSP?

Answer 14

Lesions in Striatum (putamen &globus pallidus)

Question 15

What are some Non-Speech Characteristics that may accompany AOS and reflect LH Damage?

Answer 15

1. some right-sided weakness
2. babinski reflex and hyperactive stretch reflexes
3. sometimes limb apraxia associated with LH pathology
4. If limb apraxia is present in both Right and Left sides it may be masked on the right side by hemiparesis or hemiplegia

Question 16

What are the main etiologies of AOS?

Answer 16

tumors, trauma, stroke

-anything that causes dominant hemisphere impairment of structures involved in motor planning.

Question 17

What are some pt. complaints and perceptions with AOS?

Answer 17

• 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

Question 18

What are the oral mech findings for AOS?

Answer 18

if dysarthria does not co-occur, then oral mech should be normal. (gag reflex, chewing, swallowing)
-no pathological oral reflex should exist without dysarthria.

Question 19

What is non verbal oral apraxia?

Answer 19

problems with volitional movements of oral structures while the same movements may be performed involuntarily.

Question 20

where are lesions for NVOA?

Answer 20

primarily LH.

-always assess for NVOA and Limb Apraxia in AOS eval/

Question 21

How can you assess speech in AOS?

Answer 21

voluntary speech tasks (conversational speech tasks, reading, AMR’s)

Question 22

what type of tasks are useful in assessing AOS?

Answer 22

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)

Question 23

What should you watch for in AOS?

Answer 23

• groping of articulators.

- listen for false articulatory starts

Question 24

what is the primary articulation error in in AOS?

Answer 24

distortion

Question 25

what are some other errors seen in AOS?

Answer 25

-rate, prosody, fluency

Question 26

What is the most important dx criteria for AOS?

Answer 26

• slowed rate of speech
• sound errors- distortions, consistent, predictable,
• prosodic abnormalities

Question 27

What is severe AOS?

Answer 27

Severe AOS may not initially be able to phonate and many be mute. hard to tease out the differences b/t the effects of aphasia and AOS.
If muteness lasts longer than 2 weeks, then consider another diagnosis such as severe aphasia , anorthic, or psychogenic mutism.