Ch.3- Motor Speech Exam

Question 1

What are the 5 purposes of an exam?

Answer 1

1. To give a description
2. To establish diagnostic possibilities
3. To est. a diagnosis
4. To est. implications for localization and disease diagnosis
5. To specify a severity

Question 2

What should you do to give a description?

Answer 2

provides information about the features of speech and the structures and function associated with speech. The clinician describes the patient’s speech and the structures and function of those structures

Question 3

What should you do once the description is complete?

Answer 3

the clinician will determine if the characteristics are normal or abnormal. If some aspect is abnormal, then the clinician attempts to make a differential diagnosis. In a differential diagnosis, the clinician narrows the diagnostic possibilities and tries to arrive at a specific diagnosis.

Question 4

How do you establish diagnostic possibilities?

Answer 4

After determining that speech is not normal, the clinician should determine some possible diagnoses, i.e. is this a neurological problem, is it an acquired or developmental problem, is there a motor speech disorder present, if so is it apraxia or dysarthria, if dysarthria, what type of dysarthia is it?

Question 5

How do you establish a diagnosis?

Answer 5

The clinician should attempt to make a diagnosis from the previous list. If that is not possible then put the list in order of most possible to least possible

Question 6

How do you establish implications for localization and disease diagnosis?

Answer 6

The clinician should state the diagnosis and the localization associated with that diagnosis. For example, the clinician can state that the diagnosis is spastic dysarthria which is associated with UMN involvement, or that the diagnosis is ataxic dysarthria which is associated with cerebellar involvement.

Question 7

What should happen if neurological findings are inconsistent with the SLP’s findings?

Answer 7

If a neurological diagnosis has already been made and it is inconsistent with the SLPs findings, that should also be stated. For example, if the patient has been diagnosed with ALS but the SLP finds a mixed dysarthria of ataxic-hypokinetic, it should be noted that the dysarthria findings are inconsistent with a diagnosis of ALS

Question 8

What should happen if the diagnosis is uncertain?

Answer 8

IF a diagnosis is uncertain, the SLP may indicate possible diagnoses. For example, if a stress test indicates a strong possibility of myasthenia gravis, the SLP should note this.

Question 9

Why should we specify a severity?

Answer 9

The SLP should always comment on severity for the following reasons:

1. To compare to patient’s complaints - it may provide information about a possible psychogenic component or lack of insight on the part of the patient.
2. It influences prognostic statements and decisions about how to manage the disorder.
3. It provides baseline information against which to compare progress or changes.

Severity statements usually refer to the categoreis of mild, moderate, and severe.

Question 10

What are the 4 General Guidelines for Exam?

Answer 10

1. History
2. Salient Features
3. Confirmatory Signs
4. Interpretation of Findings

Question 11

Why is history so important?

Answer 11

It’s very important. It provides information about time of onset, course of development, patient’s complaints and observations. It provides an opportunity to listen to patient’s speech without them knowing you are listening to the speech.

Question 12

What are the 6 areas of salient features?

Answer 12

1. Strength
2. Speed
3. Range
4. Steadiness
5. Tone
6. Accuracy

Question 13

In a Motor Speech Exam, What are 8 parts of a history?

Answer 13

1. Intro and goal setting
2. Basic Data
3. Onset and course of speech defecit
4. Associated Defecits
5. Patients Perception of Defecit
6. Consequences of Disorder
7. Management
8. Awareness of Diagnosis and Prognosis

Question 14

What are 15 speech mechanisms we’d examine in non speech activities?

Answer 14

1. Face at rest
2. Face during sustained positions
3. Face during movement
4. Jaw at rest
5. Jaw during sustained posture
6. Jaw in movement
7. Tongue at rest
8. Tongue in sustained postures
9. Tongue during movement
10. Velopharynx at rest
11. Velopharynx during movement
12. Larynx
13. Respiration
14. Reflexes
15. Volitional vs. “automatic” nonspeech movements of speech mucles

Question 15

What are the 5 reflexes we’d assess?

Answer 15

1. Gag reflex
2. Jaw jerk
3. Sucking reflex
4. Snout reflex
5. Palmomental reflex

Question 16

What are the 5 parts of assessing perceptual speech characterisitics?

Answer 16

1. Distinctive Speech Characterisitcs
2. Synthesizing Information
3. Tasks for Speech Assessment
4. Dysarthria Tests
5. Apraxia Tests

Question 17

What are the 6 tasks for speech assessment?

Answer 17

1. Vowel prolongation
2. AMR’s
3. SMR’s
4. Contextual Speech
5. Fatigue
6. Assess speech motor planning

Question 18

Name 1 Dysarthria test?

Answer 18

Frenchay Test of Dysarthria Assessment

Question 19

Name 5 Apraxia Tests

Answer 19

1. Apraxia Battery for Adults
2. Assessment of intelligibility in Dysarthric Speakers
3. Sentence Intelligibility Test
4. Intelligibility part of Frenchay
5. Word Intelligibility Test
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