Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Speech Disorders Across the Lifespan > Dysarthria assessment > Flashcards

Dysarthria assessment Flashcards

1
Q

Differentiating between dysarthria, AOS, and aphasia

A
  • Are speech and oral mechanisms related to neuromuscular execution?
  • Are all sub-system components affected?
  • Are deviant speech characteristics consistent and not influenced by linguistic variables?
  • Does the patient also have physiological impairments, eg. paralysis, paresis, ataxia, involuntary movements?
  • Is their speech affected by word length?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Differentiating between dysarthria types

A
  • Medical information, including aetiology
  • Speech characteristics
  • Oromotor findings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Establishing diagnostic possibilities if speech is abnormal (7)

A
  1. Is the problem neurological?
  2. Recently acquired or longstanding?
  3. Is it an MSD or another neurological communication disorder, eg. aphasia
  4. If neurologic and MSD, is it a dysarthria or AOS?
  5. If dysarthria, what type?
  6. Localised to where?
  7. How severe?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Traditional components of dysarthria assessment (4)

A
  1. Case history
  2. Neuromuscular assessment (OPE)
  3. Perceptual assessment of speech characteristics
  4. Assessment of intelligibility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Additional components of dysarthria assessment (3)

A
  1. Acoustic analysis
  2. Functional communication assessment
  3. Psychosocial impact/QOL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Possible case history topics for dysarthria

A
  • Onset and course (eg. when, fluctuate, meds)
  • Associated deficits (eg. swallowing, emotions, weight)
  • Patient’s perception (eg. appearance/feeling of face, describe speech,
  • Consequence (eg. intelligibility, repeat, participation)
  • Management (eg. strategies, SP in past, frustrating)
  • Awareness of diagnosis (eg. does doctor know, have they been provided with info)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Functional/informal assessment of dysarthria

A
  • Role play
  • Observation during daily tasks with varying speech demands
  • Over the phone/skype
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Assessment batteries for psychosocial impact of dysarthria

A
  • Dysarthria Impact Scale
  • Quality of Life in the Dysarthria Speaker
  • Semi-structure interviewing
  • Other tools: AusTOMS, social network analysis, checklists, standardised QOL scales (eg. stroke impact scale, WHO-QOL), self-efficacy scales, visual analogue scales
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Assessing environmental factors in dysarthria

A

Environmental checklist/inventory
Observation and assessment across different contexts
- Noise
- Proximity/distance
- Lighting
- Group vs 1:1
- Familiarity of listeners
- Environmental supports/technology
Identify barriers and facilitators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Assessing intelligibility in dysarthria

A
  • Primary measure of disability and is an index of severity
  • Speech intelligibility = words understood/words spoken x100
  • Standardised intelligibility assessments: single words vs sentences (ASSIDS)
  • Speech sampling: conversation, reading aloud, picture naming
  • Informal/functional tasks: eg. over the phone, large proximity, background noise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Assessment of Intelligibility of Dysarthric Speech (ASSIDS/AIDS) - use and limitations

A

Objective means of measuring intelligibility and speaking rate of dysarthric individuals
- Quantifies single word intelligibility, sentence intelligibility and speaking rate
- Record speaker producing 50 words, listener judges by multiple choice formate or transcription format, results are compared
- 22 sentences recorded, listener transcribes sentences, measure number of words correctly transcribed and duration of sample

Limitations
- Not diagnostic
- Requires judges
- Lacks norms
- Time consuming
- Reliability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is intelligibility vs comprehensibility

A

Intelligibility = degree to which the acoustic signal is understood by the listener
Comprehensibility = extent to which the listener understands the utterances produced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Assessing comprehensibility in dysarthria

A
  • Intelligibility does not = understanding, not the best measure?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical outcome assessments of dysarthria (4)

A
  • Patient-reported outcome (PRO): eg. Dysarthria Impact Scale
  • Observer-reported outcome (ObsRO): eg. Communication Effectiveness Survey completed by communication partners
  • Clinician-reported outcome (ClinRO): eg. ‘speech’ item in disease severity scale, UPDRS
  • Performance outcome (PerfO): acoustic outcomes from set tasks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complexity of speech tasks

A
  • Speech tasks can be cognitively demanding, metrically complex, or both
  • Low cog load = sustained vowel - automatic connected speech - unprepared monologue = high cog load
  • Eg. Poor performance on a motor only task like sustained vowel means it’s less of a language cog/problem and more motor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Digital/acoustic analysis of dysarthria

A

Considerations:
- Manufacturer
- Battery life
- Comparability of mics
- Recording environment
- Web-based vs in home assistants
- Ease of use
- Portability
- Budget
- Cloud vs local storage
- On boards vs API processing

Eg. computers may be more reliable at picking things up than clinicians
Eg. computers can detect pre-symptomatic Huntington’s disease

17
Q

Neuromuscular assessment for MSDs

A

Could be done with OPE or Frenchay
- Non-speech examination of the motor speech apparatus, info about speed, strength, range, tone, accuracy, symmetry, size, steadiness of orofacial movements
- Can assist diff diagnosis between AOS and dysarthria types

18
Q

OPE informal protocol described in Duffy

A
  • Assess each functional component of speech mechanism
  • Test cranial nerve and muscle function
  • Evaluate rate, strength, symmetry, tone, range, speed, accuracy
    -Evaluate type of breathing, eg. clavicular or diaphragmatic at rest/during speech/speech-like tasks
  • Count as far as possible in one breath, should be able to get to 20
  • Evaluate laryngeal/voice function, eg. prolonged vowel, pitch, loudness, voice quality
19
Q

Perceptual assessment of dysarthria, benefits, limitations

A

Using eyes and ear to idenify deviant speech features across sub-systems and hypothesise level of breakdown and classify MSD type

Benefits
- Gold standard
- Cheap, easily administered
- Widely used by clinicians
Limitations
- Subjective (intra-inter-rater reliability
- Difficulty in specifying deviant features
- Some features influence the perception of others
- Listener may be influenced by what they have just heard

20
Q

Perceptual assessment informal protocol of dysarthria

A

Speech tasks used:
- Contextual/conversation/picture description
- Reading a standard passage
- Sustained vowel, norms in Duffy
- DDK rates, norms in Duffy
- Sub-system assessment, eg. Frenchay
- Rating of overall severity/intelligibility
- Stress testing
Rate performance across dimensions on a 5 or 7 point scale

21
Q

What can a sustained vowel tell us?

A
  • > 8-9 secs considered normal
  • Make judgements regarding pitch, loudness and voice quality
  • Observe jaw, face, tongue and neck
  • Consider acoustic analysis
22
Q

What can DDK tell us?

A
  • Speech and regularity of reciprocal movements of jaw, lip, anterior/posterior tongue
  • Articulatory precision
  • Adequacy of velopharyngeal closure
  • Respiratory and phonatory support for sustaining the task
  • Want at least a 10 second sample
  • Count number of syllable repetitions
  • Easier to do via acoustic analysis, can record it and compare later
23
Q

What can stress tests tell us?

A
  • About fatigue
  • Should be done when LMN weakness of unknown origin is present OR when patient complains of rapid/dramatic change in speech with continued speaking
  • To assess fatigue, get them to read aloud naturally/count about 2 digits per second, continue for 2-4 mins without a rest
24
Q

What can FDA-2 tell us?

A
  • Sub-system assessment
  • Assessment of individual sub-systems help identify underlying pathophysiology
  • Reflexes, respiration, lips, palate, laryngeal, tongue, intelligibility
  • Rated A-E, function-no function
25
Q

What can acoustic analysis tell us?

A
  • Objective bridge between speech production and perception
  • More objective means of quantifying change over time
  • Identify factors underlying perceptual abnormalities
  • Speech sample should reflect natural speech
  • Range of tasks: DDK, sustained phonation, reading/repetition of words/sentences, conversational speech
    Same set of tasks as perceptual assessment!
26
Q

Benefits and limitations of acoustic analysis

A
  • Cost - multiple uses?
  • Expertise
  • Time
  • Development
  • Validity
  • Generalisation
  • Populations
27
Q

Dysarthria management

A

Speech Disorders Across the Lifespan (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions