CH 11 Apraxia of Speech Flashcards
what is apraxia?
problem with motor programming of speech movements
what is dysarthria?
problems with muscles/movement
what is aphasia?
a linguistic/language problem
AOS may co-occur with….?
oral and limb apraxia
AOS has also been called….?
speech apraxia and oral verbal apraxia
AOS also confused with ____ bc the phonologic impairment similarity and similar sites of lesions
Brocas aphasia
what is responsible for programming speech and how?
motor speech programmer transforms abstract phonemes to neural code from which motor programming can occur that determines specific muscle movements needed
where are motor speech plans held?
buffer area
where is MSP located
left hemisphere. structures involved are located in parietal frontal and related subcortical circuits
linguistic input to MSP comes from
perisylvan area in l. hemisphere. includes temporoparietal cortex, insula, thalamus, basal ganglia
insula is located where?
under temoral and frontal lobes
Dr. Robin has found what area to be involved in apraxia?
brodmann’s area 6
areas primarily involved with MSP?
premotor area (specifically Brocas area, supplemental motor area, basal ganglia, and cerebellar circuits), parietal lobe somatosensory cortex and supramarginal gyrus, insula, basal ganglia (striatum)
most common sites of lesions in AOS are…..
Broca’s area, insula, basal ganglia
nonspeech characteristics that may accompany AOS?
right sided weakness, spasticity, Babinski reflex, hyperactive stretch reflexes, limb apraxia
what causes apraxia?
tumors, stroke, trauma (primarily stroke)
pts with apraxia complain of…..
know what they want to say but words don’t come out right
is swallowing associated with AOS?
no. if it is present, may indicate dysarthria and dysphagia
clinical findings for oral mech exam
if dysarthria does not co-occur, gag reflex, swallowing, and chewing should be WNL and note wether or not oral sensation is impaired
clinical findings for non verbal oral apraxia
can perform involuntary movements but not involuntary
always assess for what when evaluating apraxia…?
limb apraxia, NVOA, aphasia
what can cause more severe breakdowns in individuals with AOS and Broca’s than in normal speakers?
Delayed Auditory Feedback
to assess speech, what tasks would you administer?
voluntary (conversational, narratives, reading), SMR’s and multisyllabic words and sentences, increasingly complex words (endear, endearing, endearingly), imitation tasks (to assess aphasia)
what to look for when assessing for AOS?
pts may do okay of automatic and overlearned (days of week), false articulatory starts (self correct), groping for articulators, articulatory distortions (with paraphasias seen in aphasia there are no distortions), rate and prosodic problems, non fluent
