Dysarthria & Voice Disorders Flashcards
What are examples of Organic Problems that cause voice disorders?
Structural (tumor, cleft palate)
Neurogenic (stroke)
What causes a functional voice disorder?
Muscle overuse/ misuse (vocal abuse)
What does iatrogenic mean?
Resulting from medications or medical procedures (unusual, but shouldn’t be forgotten)
What does idiopathic mean?
We don’t know what the cause is.
What 5 areas do we base a voice evaluation on?
Quality Pitch Loudness Pain/Discomfort Fatigue
What other information is gathered in an initial evaluation of a voice client?
Case History Evaluation of Structure Evaluation of Function Quality of Life Assessment Endoscopic Evaluation
What are 4 rehabilitative Interventions for Voice?
Vocal Function Exercises
Lee Silverman Voice Therapy
Laryngeal Manipulation (physical therapy for the voice’)
Resonant Voice Therapy
A group of disorders characterized by impaired ability to execute motor movement
Dysarthrias
Apraxia or Dysarthria: Artic good for automatic speech
Apraxia
Apraxia or Dysarthria: Error predictable and consistent
Dysarthria
Apraxia or Dysarthria: Visible groping postures
Apraxia
Apraxia or Dysarthira: Difficulty initiating speech
Apraxia
Apraxia or Dysarthria: Deficits involve respiration, phonation, artic, prosody, resonance
Dysarthria
Apraxia or Dysarthria: Difficulty with Imitation
Apraxia
A deficit in the planning and sequencing of movement required for production of speech
Apraxia
What is the goal for treatment of Dysarthrias?
Improve intelligibility of speech and, if possible, speech motor control
What are different ways Dysarthrias are treated?
Behavior Modification
Prosthetic Devices (palatal lift)
Medical and Surgical Procedures
Augmentative/Alternative Devices
What are the subsystems that might be affected with dysarthrias?
Respiratory (breath control) Phonatory (vocal chords, larynx) Resonance Articulatory Prosodic
What is the goal when treating Apraxia?
Increase control over articulatory movements
A voice disorder may involve any of what three voice features?
Pitch
Loudness
Quality
What is the prevalence of voice disorders?
6-10%
A change in the size of the vocal folds changes what aspect of voice?
Pitch (frequency of vibration)
An increase in air pressure from the lungs and a change in the manner of vocal fold vibration changes what aspect of speech?
Loudness (amplitude)
The complexity and special characteristics of voice, affected by the glottal pulse, is referred to as what?
Voice Quality
What are some non-organic voice problems (functional)?
Aphonia
Vocal Abuse
Psychogenic Factors causing faulty voice
What are some voice problems related to organic factors?
Laryngitis, tumors, paralysis, edema,. vocal fold webbing, granulomas, papilloma
(most organic problems alter the mass of the vocal folds or affect larynx or vocal tract.)
What is the first thing a clinician should do when a client comes in complaining of their voice not being quite right?
Refer to ENT for endoscopy
Medical treatment is NEVER initiated until after medical ______________ of the _____________.
evaluation; larynx
What are the three areas for intervention for voice disorders?
Medical (refer!)
Environmental (modify surroundings)
Behavioral (modify symptoms with therapies)
What is edema and what might it be caused by in the vocal mechanism?
Swelling, fluid in the tissues.
Caused by a number of thing, ie., vocal misuse, localized diseases, allergies, smoking, etc.
Infection that causes the vocal chords to become inflamed and immobile. No treatment other than “wait it out”
Laryngitis
What is GERD? What might it cause?
Gastro-Esophageal Reflux. It can adversely affect the voice when acid from stomach spills onto the larynx and pharynx.
What are polyps?
Benign lesions that can impede vocal contact
What are nodules?
Callous-like formations on the point of the vocal folds where the hardest “strike” occurs. Also called “singer’s nodes” or “screamer’s nodes”
What is a Papilloma?
Benign, translucent lesion on vocal folds that affects vocal fold function. No cure, but can be removed.
A child who sounds really hoarse may have this type of lesion on the vocal folds.
Papilloma
What is Webbing?
Mucous membrane that transverses glottis and can compromise airway. Surgery required.
What is a Psychogenic Voice Disorder?
A disorder that results from emotional or mental factors such as anxiety, depression, personality disturbances.
Physiological changes in the larynx may persist.
What are two primary example of Psychogenic Voice Disorders?
Conversion Dysphonia
Mutational Falsetto
This psychogenic disorder is characterized by too high pitch and incomplete closure of vocal folds. Also called puberphonia.
Falsetto (Mutational Falsetto)
Vocal folds are supposed to abduct during inhalation and adduct slightly during exhalation. Disorder where they do the reverse is ____________.
PVFD
Paradoxical Vocal Fold Movement
PVFD is often misdiagnosed as what?
Asthma
When doing a Voice Assessment, what 4 things do we judge when Listening?
Pitch
Loudness
Quality
Resonance
When doing a Voice Assessment, what objective measurements do we take?
Pitch, fundamental f., range, intensity, VOT, vowel length, nasal resonance, airflow, etc.
What visual assessment can be used for voice assessment?
Stroboscopic Assessment
What are the levels of preventative care identified by ASHA?
Tertiary: Alleviate Existing Problems
Secondary: Early Detection
Primary: Before the Fact-Educate
What are the 3 classifications for Interventions for Voice Disorders?
Medical
Environmental
Behavioral
What are some techniques used to treat vocal hyperfunction?
Relaxation Soft glottal attacks Pitch adjustment inhalation phonation yawn/sigh, etc.
What are some techniques used to treat vocal hypofunction?
Pushing/Pulling-glottal closure
Increasing loudness thru respiratory pattern
What assessment tool is useful in providing feedback on loudness and pitch?
Visi-Pitch
What 4 techniques can be used to encourage soft glottal attacks?
Yawn/Sigh
Chewing
Easy Onset
Chanting
Child voice problems are often identified by whom?
Parents or Teachers (or screenings)
Voice that emanate from a sound source other than the larynx
Alaryngeal Speech
