Ch. 4: Assessment of the Speech Mechanism

Question 1

Motor coordination

Answer 1

Parkinson’s
  Aphasia
  Dysarthria
  ALS
  Medication

Question 2

Symmetry

Answer 2

CVA
Congenital anomaly
Acquired anomaly

Question 3

Breathing

Answer 3

General physical condition
COPD
ALS

Question 4

Voice Quality

Answer 4

Velopharyngeal closure
Vocal nodules
Hoarseness

Question 5

Exterior face

Answer 5

Facial features tell us a lot about certain syndromes.
Shape of face, eyes, ears, jaw
Sensation
Tremors, tics, spasms
Weakness or extreme muscle tone?
Position of jaw at rest/mouth breather? 
Facial expressions

Question 6

Respiration

Answer 6

Look for: Postual issues/chest expansion
Tension in shoulders/neck
Evenness of exhalation
LIsten for: Shallow breathing
Stridor (noise on inhalation)
Hoarseness
Congestion
Fatigue/talking on end of breath

Question 7

Nose

Answer 7

Look & listen for:
Obstruction
Deviated septum
Swollen adenoids
Congestion
Smooth inhalation/exhalation
*Refer to doctor if needed!!*

Question 8

Lips

Answer 8

Speech sound errors
Drooling
Difficulty eating & drinking

Question 9

Jaw

Answer 9

Tempo-mandibular joint
Adequate movement
Anterior/lateral jutting
Clicking/grinding noise
Lateral/rotary movement
Upper & lower jaw meet symmetrically

Question 10

Palate

Answer 10

Divides the oral and nasal cavities.
Provides roof off which sound can resonate.
Directs the voice out of the mouth.
Hard palate must be intact to resonate speech sounds
Soft palate must be intact to open and shut nasal cavity quickly for speech and swallowing

Question 11

Mouth

Answer 11

Pretty pink color
Moist tissue
No signs of disease
Adequate height
Good arching roof
Prosthesis
Openings/fistulas
Excessively prominent ridges
Uvula…split? (bifid uvula)

Question 12

Tonsils

Answer 12

If tonsils are so big they block the airway or cause patient to have distressed breathing during the night, a physician referral may be indicated.

Question 13

Velopharyngeal insufficiency

Answer 13

The soft palate is unable to close off the nasal cavity from the oral cavity allowing air to escape through the nose during speech and food or liquid to escape through the nose during swallowing.
This could be due to structural problems or cranial nerve damage.
Prosthesis are available to help.

Question 14

Tongue

Answer 14

Soft, velvety pink color
Size
Symmetry
Mobility
The appearance of a person’s tongue can give clues as to nutrition/hydration, oral hygiene, and physical status

Question 15

Frenulum/Frenum

Answer 15

Tissue attaching the tongue to the floor of the mouth

Tongue tied

Question 16

Diadochokinesis

Answer 16

This is a method of measuring the rate at which a person can articulate repeated strings of syllables in a 10 second period to assess tongue movement and speed (puh-tuh-kuh)

Question 17

OME

Answer 17

Smile 
Puff cheeks for 10-15 seconds
Round and protrude lips
Smile and pucker 3X’s
Open and close mouth
O-E production
Say “puppy” repeatedly for 5 seconds