CH18 Managing Apraxia of Speech

Question 1

what should be worked on first before working on apraxia?

Answer 1

language if aphasia co-occurs

Question 2

principles of motor learning

Answer 2

1. drill, drill, drill
2. self monitor and self correction skills
3. “listen and watch me” approach
4. automatic speech in beginning (days of week)
5. feedback
6. use speech tasks not nonspeech tasks
7. multiple repetitions of stimuli
8. begin with consistent practice then variable
9. in beginning, reduce rate

Question 3

rosenbecks 8 step continuum

Answer 3

1. integral stimulation (pt listens then imitates)
2. clinician mimes response w/out sound during pts response
3. integral stimulation followed by imitation w/out any simultaneous cues from clinician
4. integral stimulation w/ several successive productions w/out any cues
5. pt production while looking at written stimuli
6. written stimuli, w/delayed production following removal of written stimuli (count 10 seconds)
7. response elicited by question
8. response target produced in role play situation

Question 4

wambaugh- sound production treatment

Answer 4

uses minimal contrasts to aid in refining movement patterns that differentiate sounds. works in hierarchy like 8 step continuum

Question 5

PROMPTS

Answer 5

developed for children with AOS but now used also with adults. highly structured finger placement on pts face and neck to tell articulatory placement, for sever AOS w/ limited verbal output

Question 6

melodic intonation therapy (MIT)

Answer 6

begins with hand tapping rhythms, then humming, words, phrases, and gradual fading model. emphasizes exaggerated pitch, tempo, and rhythm

Question 7

biofeedback

Answer 7

used in conjunction with other therapies, visual feedback

Question 8

severe apraxia (speechless) techniques

Answer 8

automatic speech tasks, carrier phrases, sing familiar songs, try yawning, sighing, coughing for initiating phonation, pair symbolic gestures with associated sounds

Question 9

multiple techniques for sound, syllable, word level

Answer 9

work on nonsense words rather than words with meaning, work on isolated sound and shape into words, key word technique (use initial sound of correctly produced word to lead into another word, cueing strategies

Question 10

(MIPT) multiple input phoneme therapy (for severely aphasic and apraxic pts)

Answer 10

use frequently occurring stereotypical words/phrases (go-go) as target of treatment.

1. clinician produces target many times emphasizing initial phoneme, pt taps simultaneously
2. pt joins in w/ repetitions
3. clinician fades voice but mouths utterance and taps as pt says target
4. repeat steps for other stereotypical utterances (so pt learns to say them voluntarily)
5. work on new words with same initial phonemes
6. targets broaden to include all phonemes

Question 11

(VCIU) voluntary control of involuntary utterances

Answer 11

similar to MIPT but relies on written as well as verbal input

Question 12

techniques at multiple syllable level

Answer 12

focus on rhythm, stress, and intonation while working on articulation.
use phonetic contrasts (minimal pairs)
contrastive stress tasks EX: JOHN loves mary. john LOVES mary. john loves MARY.