Chapter 16- Managing MSD's

Question 1

What are 3 focuses of management goals?

Answer 1

1. Restore lost function
2. Promote use of residual function
3. Reducing needs for lost function-must adjust to reality

Question 2

What are some factors influencing management?

Answer 2

1. Med DX and prognosis
2. Motivation and needs
3. associated problems
4. environment and communication disorders
5. health care system
6. disability and societal limitations

Question 3

what component of speech should be focused on first?

Answer 3

the one that will give the greatest functional benefit

e.g focusing on loudness in LSVT may help other areas like articulation

Question 4

What should treatment duration be?

Answer 4

as long as necessary to achieve goals but for as short a time as possible

Question 5

What does plateau mean?

Answer 5

making no more progress at that time.

Question 6

What are some approaches to management?

Answer 6

1. Medical Intervention
2. Prosthetic Management
3. Behavioral Management.

Question 7

What are some med intervention methods?

Answer 7

pharm man.: L-Dopa

Question 8

what are some surgical man?

Answer 8

improve speech deficits
-pharyngeal flap VP Function
-Surgeries for neurological condition itself, removal of
tumor or blocked arteries.

Question 9

What is involved in prosthetic management?

Answer 9

1. Palatal lift VP closure
   - sometimes used in ALSO
2. Pacing board, pointing to first letter of word or DAF for slowing rate of speech, esp, in hypokinetic dysarthria
3. Voice Amplifier- to aid in reduced intensity
4. AAC intervention- light pointers, switches,

Question 10

what are some behavioral management methods?

Answer 10

1. Speaker oriented vs. communication oriented
2. maximize communication by whatever means that will produce the most rapid, effective, natural results.
   - speaker oriented approaches (to improve speaker is the
   goal)

Question 11

what is a speaker oriented approach to behavioral management?

Answer 11

improve the speaker is the goal.

• reduce impairment by increasing physiological support.
• use compensatory strategies such as slow rate and over articulation.

Question 12

What is a communication oriented approach?

Answer 12

-structure interaction to improve speaking strategies
-give pt. hierarchy of strategies
e.g turn off tv to reduce distracting noise, bring listener to quiet corner,
give listener conversation topic.

Question 13

what does counseling and support entail?

Answer 13

providing info on the dx and future course of dz. as well as types of intervention; assisting pt in learning to live with the dz.

Question 14

what is neuroplasticity?

Answer 14

the ability of the injured brain to reorganize itself to compensate for impaired abilities.
-motor activity helps in this

Question 15

what affects cortical organization and improves performance?

Answer 15

repeated motor performance

Question 16

What are some principles of management of MSDs?

Answer 16

1. Use principles of motor learning for speech
   - improving speech requires speaking
   - drill is essential-short, frequent periods( minutes) more affective than long periods
   - both instruction and self- learning are important
   - feedback is important especially in early stages, (provided by SLP or groups, instruments)
   - frequent feedback may decrease performance compared to less frequent feedback